Medicare Part B Physician Fee Schedule Final Rule for 2021 Includes Deep Cuts Impacting AHCA/NCAL Residents

COVID-19; Medicare; Part B


Yesterday, the Centers of Medicare and Medicaid Services (CMS) issued the CY 2021 Medicare Physician Fee Schedule (PFS) Final Rule and associated Fact Sheet which establishes payment rates and other provisions related to Medicare Part B services for calendar year (CY) 2021. Services impacted include those received by residents of AHCA/NCAL member skilled nursing facilities, assisted living communities, and residences for individuals with intellectual and developmental disabilities. The final rule is effective January 1, 2021 and lists drastic payment rate cuts to physician skilled nursing facility visits; physical and occupational therapy; speech-language pathology; portable x-ray, and other Medicare Part B covered services. 

A summary of the final rule, which also includes other rule changes related to telehealth services, therapy evaluations, and therapy documentation burden reduction that are helpful to AHCA/NCAL members and their residents may be found here

AHCA/NCAL along with a large coalition of healthcare provider organizations are seriously concerned that during the middle of a global pandemic is not the time to reduce payments to essential Medicare providers by an average of nearly 10 percent and are asking for Congress to include legislation in any year-end package to prevent these arbitrary Medicare cuts in order to protect patient access to medically necessary services.

We appreciate the heroic efforts you are putting in every day in responding to the needs of your residents and staff during the COVID-19 pandemic and do not want to distract you from those efforts more than necessary, bu​t we are asking you to take a couple minutes to do the following to help fend off these cuts. 

Please contact your Members of Congress through the AHCA/NCAL Action Center to ask them to stop the Medicare cuts to providers and support the enactment of H.R. 8702Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020. This bill would provide a critical two-year reprieve from these cuts protecting access to essential care for our vulnerable residents until a more permanent solution can be implemented.

For more information about the PFS Final Rule please contact Dan Ciolek​, AHCA Associate Vice President, Therapy Advocacy.