SNMMI & Partners Urge Congress to Expand MPFS Relief into 2022

April 28, 2021

This week SNMMI and 62 organizations, representing more than one million healthcare providers, thanked Congress for its past efforts on physician reimbursement and requested the inclusion of specific provisions in future legislation. The provisions included in the letter would ensure continued beneficiary access to vital health care services by providing additional financial stability for the nation's health care system and health care workforce.

On December 27, 2020, the Consolidated Appropriations Act of 2021 was signed into law, providing temporary relief from Medicare payment cuts resulting from the planned evaluation and management code changes slated for implementation on January 1, 2021. This bipartisan effort

  • averted significant disruptions to care for Medicare beneficiaries,
  • reduced the level of cuts in 2021 for many providers,
  • supported small health care businesses — especially in rural and underserved areas — and
  • provided a lifeline for health care providers still reeling from the residual impacts of COVID-19.

Specifically, the Act delayed the G2211 add-on code reimbursement for 3 years. The money saved by the delay is intended to mitigate the 2021 Medicare Physician Fee Schedule (MPFS) final rule cuts resulting from the preservation of budget neutrality. Thus, the act increased the physician fee schedule for services furnished in CY 2021 by 3.75%. It transferred $3 billion dollars to the Federal Supplementary Medical Insurance Trust fund, to remain available until expended to pay for this fee schedule increase. The Act also required the secretary of Health and Human Services to submit a report to Congress by April 1, 2022, regarding the 2021 physician fee schedule increase.

However, the provider community is bracing for steep cuts in 2022, which could result in loss of access to essential health care services for many beneficiaries. SNMMI and the other signatories to the letter urged Congress and the administration to make a critical investment in the nation’s health care infrastructure by providing an additional $3 billion for the MPFS to once again mitigate expected reductions to the Medicare conversion factor, ensuring financial stability for physicians and practices in 2022. Maintaining this level of funding, which would equate to a 3.75% increase for all payments across the fee schedule, would allow healthcare providers to continue to focus on addressing patient backlogs and identifying effective treatments for patients impacted by the pandemic.

A current version of the MPFS may be viewed here.