Blog Post

COVID-19 Relief Bill Affects 2021 MPFS Update Preparations

Covid Relief Web

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 10.2% lower conversion factor, and all of the new codes.
  • Congress placed a moratorium on payment for the new add-on G2211 code for three years until January 1, 2024. This is presumably designed to allow providers to get used to coding, documenting, and billing this CPT code (section 113 of the bill).
  • Further, to financially support physicians, Congress funded a one-year increase of the conversion factor of 3.75%. This is anticipated to increase the conversion factor from $32.41 to approximately $33.62 (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. Financial implications related to the incongruence of a live billing code that may not yield any reimbursement could present major challenges. Our work with groups nationally has revealed that there are a few options on how to proceed with distributing compensation to physicians in 2021.

Several factors—including composition of your group, operational readiness of the team, and your group’s economic position—will impact the option that you choose, but the solution will require immediate attention.

Continue to check back here to learn more or confer with your ECG adviser regarding these changes.

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