This week the Centers for Medicare & Medicaid Services (CMS) released the 2021 Medicare Physician Payment Schedule (PFS) Final Rule. Within the Rule CMS stated that they would move forward with the AMA-RUC recommended revaluation of total joint arthroplasty CPT codes, “finalizing the RUC-recommended work RVU of 19.60 for CPT code 27130 and the RUC-recommended work RVU of 19.60 for CPT code 27447” in spite of “many commenters” in overall opposition to the proposal. Further, CMS is also imposing program-wide cuts to the conversion factor of E/M services that negatively affect all surgical specialties. CMS states these cuts are required by law to maintain PFS budget neutrality in light of improved rates to primary care providers for E/M services.

In the meantime, we continue to work against these cuts. A bicameral, bipartisan letter from Congress was sent last week, urging CMS to work with stakeholders regarding the PFS revaluations. For additional information, read the letter. This letter followed up on a letter sent in June by 37 Members of the House of Representatives. AAHKS would like to recognize Senator John Barrasso (R-WY), Senator Sherrod Brown (D-OH), Representative Brad Wenstrup (R-OH), Representative Terri Sewell (D-AL) and Representative Andy Harris (R-MD) for their support and leadership on these letters. CMS invited stakeholders to continue to engage on the potential to capture joint arthroplasty preservice time through other CPT codes.

AAHKS leadership greatly appreciates the great effort from our members, from meeting with CMS, Congress and the Administration, to the thousands of letters sent to Congress and CMS on this issue. To continue the fight, if you have not already done so, please write Congress in support of H.R. 8702, the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020,” which would protect specialty healthcare professionals who are caring for our nation’s vulnerable Medicare population and preserve vital access to musculoskeletal services. If passed, this legislation would provide a “relief payment” in 2021 and 2022 that would allow Medicare physician reimbursement to remain at 2020 levels for 2 more years regardless of CMS’s cuts.

For more information, read our summary.