March 4, 2021
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2021 Update
This article informs you that the Centers for Medicare & Medicaid Services (CMS) issue payment files based on the 2021 Medicare Physician Fee Schedule (MPFS) Final Rule, published in the Federal Register on December 28, 2020.
Section 1848(c)(4) of the Social Security Act authorizes the Secretary of the Department of Health and Human Services (HHS) to establish ancillary policies necessary to implement relative values for physicians’ services. The updated payment files are effective for services furnished between January 1, 2021 and December 31, 2021.
Summary of Changes for April 2021
Below is a summary of the changes for the April update to the 2020 MPFS. Unless otherwise stated, these changes are effective for dates of service on and after January 1, 2020. These changes will be implemented on April 5, 2021.
New Codes effective for dates of service January 1, 2021, and after.
CODE |
ACTION |
---|---|
G2211 |
Procedure Status = B; there are no RVUs, payment policy indicators do not apply. |
Updated Codes, effective for dates of service April 1, 2021, and after.
CODE |
ACTION |
---|---|
A9592 |
Procedure Status = X; there are no RVUs, payment policy indicators do not apply. |
G2172 |
Procedure Status = X; there are no RVUs, payment policy indicators do not apply. |
J1427 |
Procedure Status = E; there are no RVUs, payment policy indicators do not apply. |
J1554 |
Procedure Status = E; there are no RVUs, payment policy indicators do not apply. |
J7321 |
Short Descriptor = Hyalgan supartz visco-3 dose |
G9868 |
Short Descriptor = CMMI asyntelehealth <10min |
G9869 |
Short Descriptor = CMMI asyntelehealth 10-20min |
G9870 |
Short Descriptor = CMMI asyntelehealth >20min |
J7333 |
Procedure Status = I |
J7401 |
Procedure Status = I |
J7402 |
Procedure Status = E; there are no RVUs, payment policy indicators do not apply. |
J9037 |
Procedure Status = E; there are no RVUs, payment policy indicators do not apply. |
J9349 |
Procedure Status = E; there are no RVUs, payment policy indicators do not apply. |
Q2053 |
Procedure Status = E; there are no RVUs, payment policy indicators do not apply. |
S1091 |
Procedure Status = I; there are no RVUs, payment policy indicators do not apply. |
A technical correction associated with indirect PE allocation was applied to HCPCS codes G2082 and G2083 in the CY 2021 Physician Fee Schedule final rule. Since this technical correction was applied too late to allow for discussion in the preamble text of the rule, we are reverting this change for the 2021 calendar year, retroactive to January 1, 2021.
RVU changes are effective for dates of service January 1, 2021, and after.
CODE |
ACTION |
---|---|
G2082 |
Non-facility PE RVU = 24.06; Facility PE RVU = 0.27 |
G2083 |
Non-facility PE RVU = 34.72; Facility PE RVU = 0.27 |
If you have questions, contact the CGS Provider Contact Center at the appropriate number listed below and choose Option 1.
Part A – 1.866.590.6703 |
Part B – 1.866.276.9558 |
Home Health and Hospice - 1.877.299.4500 |