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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

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