The California Medical Association (CMA) and a broad provider coalition are urging Congress to stop the proposed 2021 Medicare payment cuts to non-primary care providers. 

On August 3, 2020, the Centers for Medicare and Medicaid Services (CMS) published its proposed 2021 Medicare Physician Fee Schedule. In the proposal, CMS indicated it is moving forward with the overhaul of the evaluation and management (E/M) office visit coding, documentation and payment system. While CMA appreciates that CMS is proposing to implement long overdue and substantial payment increases for office visits, we are opposed to the corresponding payment cuts to the non-primary care specialties. 

When the E/M coding changes were first proposed, the American Medical Association (AMA) CPT Editorial Panel and the AMA/Specialty Society RVS Update Committee (RUC) convened a workgroup to make recommendations on the E/M overhaul. Although, agency had largely accepted AMA’s recommended changes, the CMS proposal does not apply the office visit increases to the global surgery payment bundles. Because of the Medicare fee schedule budget neutrality requirements, the primary care office visit increases and other new policies are being offset with cuts to the surgical specialties.   

CMA is urging Congress to waive the budget neutrality requirements, which will stave off the payment cuts to non-primary care physicians slated to take effect on January 2, 2021. CMA is concerned that some physicians will be forced to close their practices or retire early because of the negative cumulative effect of the pandemic-related revenue losses and the Medicare fee schedule cuts. CMA believes the substantial payment cuts will harm seniors’ access to physicians during the COVID-19 pandemic – a time when patients need physicians more than ever. 

California physician Congressman Ami Bera, M.D., will be introducing legislation to waive Medicare’s budget neutrality requirements in order to protect the primary care payment updates while preventing the cuts to non-primary care specialists.

CMA asks physicians to urge their Members of Congress to support this legislation and to stop the cuts.

For more details, see the “Halt the Medicare Payment Cuts” fact sheet.