December 15, 2020
Yesterday, SNMMI and a coalition consisting of 77 medical societies sent a letter to Congress in support of S. 5007, a bill to halt pending Medicare payment cuts resulting from the planned evaluation and management (E/M) code changes slated for implementation on January 1, 2021.
Although SNMMI agrees with the adoption of the new E/M coding structure recommended by the American Medical Association, this will result in significant payment reductions to nuclear medicine (~8%) and radiology (~11%) services unless the government removes the budget neutrality requirements. The planned decrease in the 2021 conversion factor will be below the 1994 conversion factor of $32.9050 — which is worth approximately $58.02 today. The MPFS final rule will also negatively impact our membership who, to a large extent, provide few E/M services.
This critical legislation recognizes the importance of allowing significant, scheduled increases in reimbursement for primary care physicians and others who chiefly provide E/M services while also avoiding the devastating corresponding cuts for physician and non-physician providers that would occur because of Medicare’s budget neutrality requirements. Given the ongoing COVID-19 pandemic, it is more important than ever to halt the implementation of any payment reductions that could inadvertently limit patient access to care as well as further exacerbate the financial instability of health care provider practices.
SNMMI and the coalition support S. 5007, which would provide two years of much-needed stability for Medicare providers as they continue to strive to meet the needs of patients during this public health emergency. S. 5007, introduced on December 10 by Senator John Boozman (R-AR), is virtually identical to H.R. 8702, the “Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020,” which now has 97 cosponsors. SNMMI and 73 medical societies have signed onto a letter of support for this bill. Both bills would protect Medicare payment rates for services provided by our members and other healthcare providers, establishing 2020 Medicare reimbursements as the floor for payments in both 2021 and 2022.