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ACP Says Medicare’s Announced Payment Increases for Office Visits Are Essential to Patient Care

 Urges Congress to Fully Support Implementation on January 1 as Finalized by CMS

Statement attributable to:
Jacqueline W. Fincher, MD, MACP
President, American College of Physicians

Washington, DC (Dec. 2, 2020) — The American College of Physicians (ACP) strongly supports the increases in Medicare payments to physicians for evaluations and management (E/M) services that were included in the final 2021 Medicare Physician Fee Schedule (MPFS) released on Dec. 1, and calls on Congress to ensure that they are fully implemented on Jan. 1 as finalized by CMS.

The 2021 MPFS will increase payments for many office visits and related E/M services, create new “G” codes that will allow physicians to get additional payments for complex visits and visits that take more time than usual (prolonged services), and increase payments for care coordination. ACP notes that these improvements, while long overdue and absolutely essential, only partially offset the huge losses of revenue from the COVID-19 pandemic experienced by internal medicine specialists and other frontline physicians. While CMS’s rule will help them keep their practices open at a moment when patients in their communities desperately need access to their care, additional policies will be needed to address the decades-old underinvestment in primary and comprehensive care. 

ACP notes that the application of budget neutrality (BN) to offset the budget cost of the increased payments for E/M and other services in the 2021 MPFS will cause reductions in Medicare’s dollar conversion factor for all physician services and specialties. ACP is supportive of Congress acting to prevent BN cuts for Calendar Year 2021 provided that such legislation does not in any way diminish or delay the improved payments for office visits and other related E/M services, including the new G codes for complex visits and prolonged services as finalized by CMS for implementation on January 1, 2021.

In addition to the scheduled increases in payment for office visits and other related E/M services, ACP specifically supports, and calls on Congress to support, CMS’s decision to implement a new code to better recognize a particularly complex patient visit. Code G2211 will allow physicians to account for services like chronic disease management tracking, reviews of consult or lab reports, medication-related monitoring and safety outside of patient visits, and physician input at assisted living or nursing homes. All of these actions take considerable physician time, yet have not previously been compensated.

The payment improvements will go a long way to helping physician practices over the next year as we continue to deal with COVID-19, and in the future. We need to ensure that practices across the country are able to continue to operate and provide frontline care in their communities.

Contact: Jacquelyn Blaser, (202) 261-4572, jblaser@acponline.org

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About the American College of Physicians

The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 163,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter, Facebook, and Instagram.