Medicare 9% cut averted for now with a smaller cut in 2021

Thanks to everyone’s efforts in contacting their legislators, on December 21, Congress passed legislation that addressed COVID relief and the 9% cut contained in the 2021 CMS Medicare fee schedule.

Here’s what the bill contains:

• The conversion factor (CF) for 2021 is statutorily increased by 3.75% from what CMS put in place for 2021 (i.e., the 9% cut), but only for 2021.
• The 2% Medicare Sequestration cut moratorium will be extended for three months, making this cut effective April 1, 2021, instead of January 1, 2021.
• So here’s the math. The combined 3.75% CF increase, plus budget neutral removal of G2211, results in a CF of about $34.52. That’s a 4.5% reduction from CY2020. Because of the increase in some of the codes for therapists, this translates to a cut to therapy of about 3.6% compared to 2020 for January 1, 2021 through March 31, 2021.
• Effective April 1, 2021, the cut to therapy will be about 5.6% when compared to 2020 — UNLESS the restoration of the 2% sequestration cut is delayed again by Congress (i.e., the moratorium is continued).

While a 3.6% cut is not what we were hoping for, and is not great news, it is better than a 9% cut. We will continue to work with other organizations to make Congress aware of the needs of therapy providers. PTPN members will receive an email today with a memo outlining all the changes and new provisions in the bill of interest to therapists.

Together we can make a difference.