Includes key changes impacting palliative care reimbursement.

On December 1, 2020, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the calendar year 2021 Physician Fee Schedule. As anticipated, CMS has increased the value for office/outpatient Evaluation & Management (E&M) codes, with some experts predicting an increase as high as 17%. Note, however, that due to budget neutrality requirements, other codes, including home-based visits, have decreased in value; legislation to delay these cuts has been introduced and may still impact actual 2021 payments. In addition, CMS has added several codes commonly used by palliative care clinicians to be reimbursed when provided via telehealth – meaning both audio and video – including care planning for cognitive impairment (99483) and home-based visits (99347-99350). While the telehealth additions are positive, they can only be used in rural areas outside of the under the public health emergency.

A fact sheet describing these and other features of the 2021 Physician Fee Schedule can be found here.