CMS Releases 2021 MPFS Proposed Rule

August 4, 2020 
Delena Supinski 
Director of Account Management 

CMS (Centers for Medicare and Medicaid Services) released the MPFS (Medicare Physician Fee Schedule) Proposed Rule for the 2021 calendar year on August 4, 2020. The most significant change to specialty physicians is an 11.9 percent decrease in the Conversion Factor from $36.09 in 2020 CY to $32.36 in CY 2021.

For Radiology, the impact of this decrease on common CPT® codes such as 71045 (Chest 1 View) and 70551 (MRI Brain without contrast) is a 12% decrease in the allowed amounts for both codes. The estimated impact across all Radiology specialties is diagnostic radiology (-11%), interventional radiology (-9%), nuclear medicine (-8%), radiation oncology (-6%), and radiation therapy (-6%).

Other proposed changes include: 
1. 40 new or revised codes that affect radiology
· New code for low-dose CT for lung cancer screening
· Reduced values for diagnostic chest CT codes
2. Permanent permission for “mid-levels” (NPs, PAs, clinical nurse specialists, nurse midwives) to supervise diagnostic tests
· Consistent with state law and licensure
· Must maintain the required relationships with supervising/collaborating physicians as required by law
3. Continue to permit direct supervision to be met with “electronic presence” (real-time audio and video technology) through December 31, 2021
4. Extended payments for telehealth codes
5. New codes for telehealth services

The proposed rule with comment went on display at the Office of the Federal Register’s Public Inspection Desk on August 4, 2020 and will be available until the regulation is published on August 18, 2020. The “Comment Period” will close on October 5, 2020.

You can view the Calendar Year 2021 Physician Fee Schedule Proposed Rule here.
You can view the CMS Fact Sheet here.

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