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01/05/2021

COVID Relief Bill and Consolidated Appropriations Act Included Many Changes Affecting Your Medicare Payments

The Consolidated Appropriations Act, 2021, which consists of the 12 appropriations bills, as well as a COVID-19 economic releif package.  It is 5,593 pages and not only included the $600 per-person payments, $300 weekly unemployment checks, an eviction ban, additional payroll protection money and so much more, it also included many updates to the Medicare program.  Below you will find a brief summary some of the items that will likely affect your oncology program;

  • Suspended the payment adjustment percentage of 2% applied to all Medicare Fee-For-Service (FFS) claims through March 31, 2021.  (Previously extended from May 1 through December 31, 2020). 
    • Page 769
  • Allows for a one-time 3.75% increase in the conversion factor for all services paid under the physician fee schedule during 2021.
    • Page 768
  • Disallows Medicare from reimbursing the E & M Specialist code, G2211 for 3 years.
    • Page 1766
  • Expanded access to clinical trials by approving the clinical trials Act, H.R. 913.
    • Page 1808
  • Delays the start of the Radiation Oncology Model until January 1, 2021.
    • Page 1795
  • A two year freeze of the Advanced Alternative Payment Model incentive thresholds to determine eligibility for the 5% incentive payment.

CLICK HERE to review the ACT

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