Medicare 10% Reduction in Reimbursement for Anesthesia has been reduced to 3%, effective 01/01/2021
The approximate 10 percent reduction in the anesthesia conversion factor (CF) scheduled to take effect on Jan 1, 2021 has been modified. A statement published by the American Society of Anesthesiologists (ASA) provided the following take on the CAA:
The scheduled cut to the anesthesia conversion factor will be reduced to a 3% cut rather than the previously proposed 10% cut. An improvement, but still entirely inadequate for a specialty already hampered with a flawed payment rate, whose members are caring for COVID-19 patients on the frontlines of the pandemic.
According to an update released by the Centers for Medicare and Medicaid Services (CMS), the new national anesthesia CF will officially be 21.5600 for 2021 instead of the originally set anesthesia CF of 20.0547. This translates to a 2.9 percent reduction from the 2020 anesthesia CF, which is far better than the 9.7 percent reduction that was authorized in the 2021 Medicare Physician Fee Schedule (PFS) Final Rule. Your exact anesthesia CF will vary depending on your geographic location. You can search for the CF in your area by going to the following CMS link: Anesthesiologists Center | CMS.
Call to action: Tell Congress to hold health plans accountable for surprise billing
In recent months, Congress introduced a number of bills that address the issue of surprise billing. There is widespread agreement that patients should be protected from surprise medical bills and taken out of the middle of payment disputes. However, the current legislative “solutions” give too much power to health plans. Instead of the discounted in-network benchmark rate solution proposed by many of these bills, MGMA advocates for out-of-network payments to be set by leveraging commercial data from independent sources. When this payment rate is insufficient, an independent dispute resolution process should be utilized to determine fair payment for the physician.
Please take a moment to submit a letter to Congress through our Contact Congress portal and ask your representatives to hold health plans accountable for providing adequate provider networks, so that surprise bills do not ocurr.
