E/M-erging payment rates: Effects of 2020 federal funding legislation on the 2021 Medicare Physician Fee Schedule

This white paper details the effects of recent federal funding legislation on the 2021 Medicare Physician Fee Schedule. On December 27, 2020, Congress passed the Consolidated Appropriations Act of 2021 (H.R. 133), a sweeping package to fund the federal government for fiscal year 2021, as well as provide another round of coronavirus emergency response and relief. The law also provides an additional $3 billion in funding for the Medicare Physician Fee Schedule (PFS) in 2021 to offset payment cuts for procedure-focused physicians. It also phases in the reimbursement shift from procedure-focused physicians to patient interaction-focused physicians from 2021 to 2023, with full implementation in 2024. The report covers the fee schedule, the impacts on physician payments under traditional Medicare, and implications for health plans and providers.