The recently finalized 2021 MPFS rule prompted a significant number of questions and confusion from the market. Partly in response to this feedback, the COVID-19 relief bill that was passed on December 21 includes significant changes with regard to the work relative value unit (WRVU) conversion factor and the somewhat controversial G2211 visit complexity add-on code. Below are the takeaways that you and your physician enterprise need to know.
- The 2021 MPFS is still being implemented as finalized, including the higher WRVU values for E&M codes, the lower conversion factor, and all of the new codes.
- Congress placed a moratorium on payment and use for the new add-on G2211 code for three years until January 1, 2024.
- Further, to financially support physicians, Congress funded a one-year increase of the conversion factor of 3.75%. This, when combined with a sequestration delay, is anticipated to increase the conversion factor from $32.41 to approximately $34.89 (section 101 of the bill).
- These two related but unsynchronized patches to the G2211 code and the conversion factor will slow the rollout of the changes, making the implementation steps and messaging to physicians even more challenging.
Because of the COVID-19 relief bill changes, current plans for physician compensation in 2021 will need to be reconsidered, and preparations for 2022 should be initiated. Adjustments must incorporate the financial implications to your group, anticipated benchmark survey challenges, and your group’s compensation model structure.
Several factors—including composition of your group, operational readiness of the team, and your group’s economic position—will impact the the changes you make, but the solution will require immediate attention.
Published December 23, 2020