Nearly 100 U.S. lawmakers last week submitted a letter to Seema Verma, administrator of the Centers for Medicare & Medicaid Services, that expresses concerns regarding a proposal that would slice 8% from Medicare payments for physical and occupational therapy services.
“Concerns about whether the implementation of certain aspects of this rule will reduce access to health services has been raised to us,” they wrote. “To better respond to these concerns, we are requesting additional information regarding the process by which CMS reached the decision to reduce the reimbursement for services furnished by certain providers in 2021 to accommodate for the increases to the values of the office/outpatient [E/M] codes.”
CMS’ 2020 Physician Fee Schedule Payment System Final Rule seeks to strengthen Evaluation and Management (E/M) Services coding and increase payments for office and outpatient E/M visits. It would become effective in January 2021.
Medicare Part B therapy services would see an 8% reduction under the change. Providers have stated that the cuts are a way for CMS to offset the E/M payment increases. They’ve also warned that the reduction in Part B services would directly affect skilled nursing facilities’ billing of Part B therapy — which could ultimately have a negative impact on residents.
The letter asks CMS to explain the agency’s methodology and data used to calculate the estimated impact the coding change would have on each specialty. It also asks the agency what additional information it would consider before preparing the final 2021 fee schedule, and if it contemplated how the changes may impact beneficiary access to the specialty services.
Lawmakers asked for a response no later than Feb. 21.