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Healio: ACR commends reimbursement boost for cognitive care in 2021 Medicare Fee Schedule

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Washington, December 8, 2020 | comments

The American College of Rheumatology has praised CMS for approving “long awaited” updates to cognitive care reimbursements for Medicare, increasing the amount for evaluation and management services.

In a press release, the ACR stated that the update, part of CMS’ 2021 Medicare Physician Fee Schedule final rule, clears the way for “much needed” increases in Medicare reimbursement for E/M services, including examinations, disease diagnosis, risk assessments and care coordination.

“For many years, Medicare reimbursement did not adequately reflect the time and skill required to provide high-quality cognitive care, including rheumatology care,” David Karp, MD, PhD, president of the ACR, said in a press release. “These updates are critical to the future of the rheumatology specialty and the continued delivery of high-quality rheumatology care for millions of Medicare beneficiaries.”

According to the ACR, CMS in 2018 proposed a code collapse that would have resulted in significant cuts to rheumatology care for Medicare beneficiaries. However, after hearing concerns and recommendations from more than 170 medical groups and specialty societies, including the ACR and the American Medical Association, CMS reversed course, and later drafted and finalized the current update.

The reimbursement increases take effect Jan. 1.

“These E/M improvements are the result of years of advocacy by rheumatologists and patients that educated policymakers about the importance of time spent with patients for chronic disease management,” Blair Solow, MD, chair of the ACR’s Government Affairs Committee, said in the release. “We commend CMS for recognizing the value of the care provided by rheumatologists and rheumatology health professionals.”

However, not all issues related to the fee schedule have been settled. To ensure that the E/M rate increases do not result in cuts to other medical specialties, such as physical and occupational therapists, the ACR is calling on Congress to pass legislation in the House of Representatives that would waive budget neutrality adjustments for 1 year. The bill, H.R. 8505, was introduced in the U.S. House of Representatives in October by Rep. Michael Burgess (R-TX) and Rep. Bobby Rush (D-IL). It has been referred to the House committees on Energy and Commerce, Ways and Means, and Appropriations.

“Budget neutrality via H.R. 8505 is a fair and reasonable approach to ensure needed cognitive care updates are not made at the expense of other specialties,” Solow said in the release. “We encourage congressional leaders to swiftly pass this legislation.”

Published here.
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