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The presidential election victory for Joe Biden, who surpassed the 270 electoral votes needed to snag the win after voting continued over the weekend, could have significant ramifications within the health care delivery system, and for medical groups specifically.
 
HHS Secretary Alex Azar has reauthorized the declaration of a pubic health emergency (PHE), meaning the PHE and its special rules for providers remain in effect at least through the end of the year.
The Quality Payment Program is delaying a major overhaul planned for 2021: Its MVP (MIPS Value Pathways) upgrade, which was meant to move participants “away from siloed activities and measures and towards an aligned set of measures that are more relevant to a clinician’s scope of practice,” has been delayed due to “stakeholder concerns” and COVID-19. Instead, CMS will make “additions to the framework’s guiding principles and development criteria” for 2022.
 
 
You can expect to see wild swings to Medicare pay rates in 2021, according to proposals CMS released this morning. The agency announced a nearly 11% cut to the Medicare physician fee schedule’s conversion factor (CF), dropping it to a rate of $32.26 next year, down from $36.09 in 2020.
 
Influencing the substantial decrease to the CF are the projected pay increases to the core set of E/M office visit codes (99202-99215). CMS confirmed that the E/M office visit codes remain on track for their first major overhaul in 25 years, according to the proposed 2021 Medicare physician fee schedule.
 
 
Coders and medical practice staff can get a head start on a series of updated rules for diagnosis coding – the 2021 version of the ICD-10-CM Official Guidelines on Coding and Reporting was issued today – weeks ahead of the typical early August release date.
 

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