COMMENTARY

How Does the COVID-19 Stimulus Bill Affect Physician Payments?

Betsy Nicoletti, MS

Disclosures

January 12, 2021

Don't Use the Code for Inherent Complexity; You Won't Be Paid

Congress prohibited CMS from implementing payment for G2211 or any similar code for 3 years. Medical practices that were planning on using G2211 in January should not begin using the code, as there will not be payment tied to its use.

Most RVU changes for office visits are increased as such:

 

2020
work RVU
(wRVU)

2020 total, non-facility RVU

 

2021 wRVU

2021 total, non-facility RVU

99202

0.93

2.14

 

0.93

2.13

99203

1.42

3.03

 

1.60

3.28

99204

2.43

4.63

 

2.60

4.93

99205

3.17

5.85

 

3.50

6.51

 

         

99211

0.18

0.65

 

0.18

0.68

99212

0.48

1.28

 

0.70

1.67

99213

0.97

2.11

 

1.30

2.68

99214

1.50

3.06

 

1.92

3.81

99215

2.11

4.11

 

2.80

5.33

These increases will benefit all practices that utilize office visit codes. Medical practices that base compensation on wRVU productivity should be prepared for changes.

Since April 2013, CMS has reduced Medicare payments to physicians by 2%. Congress put a pause on that during the pandemic, and this law continues that pause during the first quarter of 2021. Additionally, CMS won't apply the 2% fee reduction due to sequestration through March 31, 2021. This continues the delay implemented by CMS previously that physician groups advocated for strenuously.

In conclusion, this late-breaking Congressional action will affect all practices. The increase in RVU values for office visits is welcome news for many specialties, and the boost to the conversion factor is a relief to all.

The American Medical Association estimates that, on the basis of these changes, most specialties will now see either a neutral or positive change in fees for 2021. The drastic decreases projected by Medicare in its Final Rule are erased by the provisions enacted by Congress.

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