ACI Alliance Joins Coalition to Mitigate Cuts in Medicare Services Reimbursement

12/9/2020

CMS is moving ahead with plans to reduce reimbursement for many categories of providers including those who provide CI services.  The specific impact on CI services reductions is shown below.

Reimbursement
CMS released their final Physician Fee Schedule rule for 2021. Unfortunately, they did maintain the cuts for audiologists (6%) and SLPs (9%) as well as others. Attached is a spreadsheet on specific CI related codes. The rule takes effect on January 1, 2021. The cut is due to the rule’s payment increases for evaluation and management (E/M) services that require offset to meet the budget neutrality requirements. Across the board, the conversion factor used to determine payment amounts will be decreased by almost 11%, from $36.09 in FY 2020 to $32.26 in FY 2021. The American Medical Association and other stakeholders had urged CMS to delay or phase-in the budget neutrality adjustment, but CMS did not believe they had legal authority to do so. 

Stakeholders are now pushing legislation that would accomplish the same thing. There is currently a broad group of medical organizations (over 300) working to slow down or mitigate these cuts.  They are pushing for passage of a bill, H.R. 8702, the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020.  This bill would “provides a necessary reprieve for a broad array of physicians and non-physician health care providers facing substantial payment reductions in the coming months, while also allowing payment increases to go forward for those who provide E/M services to Medicare beneficiaries in a stand-alone office visit or outpatient setting.” (Pulled from the press release).  The list of supporters is here and I encourage us to join them. I am somewhat skeptical that it will pass, but participating in the group will also allow us to hear of other efforts quickly so we can respond to best suit our members. 

Medicare Telehealth Services List
CMS finalized the addition of services to the Medicare telehealth services list on a permanent basis (“Category 1”) as well as temporary additions for the duration of the public health emergency (“Category 3”). None of the codes we requested to be added to the Category 3 list in our comments -- CPT codes 92601-92604 – were added to the list of expanded telehealth services. The final rule notes that they received comments requesting audiology service additions to Category 3, including device evaluation, but CMS states that ultimately they felt those interactions were not appropriate for audio/video communication, and instead required in-person interaction.

However, some speech language codes were, in fact, added to the Category 3 list, 92521-92524 and 92507, which focus on speech fluency, speech sound production, and auditory processing disorder. 

We will continue to support Telehealth after the health emergency including several new bills that will be introduced.

Reimbursement Reductions in CI Related Services