The Consolidated Appropriations Act, 2021 has modified the Medicare Physician Fee Schedule (MPFS). Two major impacts under the Act include:
- A 3.75% increase in MPFS payments for CY 2021
- Delayed implementation of the inherent complexity add-on code for evaluation and management services (G2211) until CY 2024.
Additionally, the conversion factor was revised to reflect the 3.75% increase. The CY2021 conversion factor is now 34.8931.
G2211 was finalized in the MPFS final rule as an add-on code to E/M services. G2211 was to capture visit complexities of service related to ongoing care to a patient’s single or complex condition. The code was designed to be used in addition to an E/M service and also available for telehealth. The estimated reimbursement was approximately $11-15.
Practices may have configured their 2021 charge system and EMRs to capture the new code. Due to the Act, the implementation of this currently delayed until 2024.