The last week of a tumultuous year brings even more changes for physician practices…all at the last minute.
On Sunday, December 27, the President signed the Consolidated Appropriations Act of 2021 (a 5000+ page document) which includes two provisions that are immediately noteworthy to Acumen client practices.
- A delay in implementation of G2211 (the so-called “complexity adjuster code”) until at least January 1, 2024, for Medicare beneficiaries. The implementation of G2211 had been scheduled to go into effect on January 1, 2021, and would have increased reimbursement for addressing health needs with consistency and continuity over time and would likely have been applicable for a large percentage of nephrology office visits.
- An increase in the Physician Fee Schedule conversion factor of 3.75% ($37.44 final conversion factor for 2021). This increase is in stark contrast to the 10% reduction that had been scheduled for January 1, 2021, and provides relief to many practices. (In order to make this change, Congress waived the budget neutrality requirement.)
It is important to note that other changes associated with E/M coding for 2021 (for example, the emphasis on Medical Decision Making and Time as the key drivers for medical coding described here) will still go into effect on January 1, 2021.
For Acumen 2.0, we had planned to roll out changes to the Wrap-Up Activity to make it easy to assign G2211 codes for appropriate visits starting on January 1, 2021. But we are now actively removing those changes in light of the legislatively mandated delay in G2211 implementation for Medicare beneficiaries.
There are other provisions in the Act worth noting (including provisions to reform surprise billing and an extension to the budget sequester moratorium until March 31, 2021. We are continuing to review the Act as of press time, but we believe that the two items noted above are worth your immediate attention.
What are your thoughts? Have you found additional items in the Act that would be helpful for the Acumen community to know? Please join the conversation!
Timothy McNamara, MD, MPH is Sr. Director of Clinical Health IT in FMCNA Medical Office, and serves as Acumen’s Medical Director. Dr. McNamara is a physician with an extensive health informatics background. He brings 26 years of experience in healthcare IT from work in both corporate and academic environments.
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