Monthly Coding and Reimbursement Tips
Medicare 2021 Proposed Rule Action Needed
The Centers of Medicare and Medicaid Services (CMS) released the 2012 Medicare Physician Fee Schedule (MPFS) proposed rule on August 3, 2020. Unfortunately, in this proposed rule, the conversion factor would be decreased from $36.03 to $32.26. This amount is multiplied by the relative value unit of each code and the geographic adjustment factor to create the allowable rate for each covered procedure. As a result, audiology is slated to get a 7% reduction in the allowable rates of their covered services.
The proposed rule also still does not allow for expanded coverage of audiology services delivered via telehealth and still requires, for coverage, the physician order.
It is very important that audiologists submit a comment to CMS and write their Senator and Congressperson and oppose these reductions and care restrictions, especially given the financial challenges of a COVID response. All comments are due by October 5, 2021.
Resources for submitting comments and opposition: