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Potential 2021 Medicare Part B Payment Reductions

Audiologists and speech-language pathologists (SLPs) are set to experience significant payment reductions for Medicare Part B (outpatient) services beginning in 2021. Learn more about the reductions, ASHA’s ongoing advocacy, and how you can help stop the cuts.

Contact your members of Congress to urge them to stop the Medicare payment cuts for outpatient audiology and speech-language pathology services. 

The payment cuts impact audiologists, SLPs, and many other Medicare providers.

In its release of the 2021 proposed Medicare Physician Fee Schedule (MPFS), the Centers for Medicare & Medicaid Services (CMS) projected a 7% decrease in payment for audiology services and an 9% decrease for speech-language pathology services. Audiologists and SLPs are not the only providers seeing significant payment reductions in 2021. For example, projected decreases include 9% for cardiac surgeons, 10% for chiropractors, and 11% for radiologists, among others.

ASHA will submit formal comments on the proposed rule to CMS as part of the public comment period. CMS must respond to public comments before publishing the finalized MPFS in December (due to the late August release of the proposed rule) for implementation on January 1, 2021.

CMS is reducing rates to offset 2021 payment increases for evaluation and management (E/M) services.

CMS finalized changes to office-based outpatient E/M procedure codes, resulting in payment increases for primary care services beginning in 2021. Every year, CMS must ensure that rate changes for all procedure codes paid under the MPFS remain budget neutral, as mandated by law. As a result, Medicare Part B providers may see incremental decreases in payments annually when CMS shifts funding to accommodate increases in payments for other services. The proposed 2021 negative impacts to audiologists and SLPs are higher than usual because of the significant increase in value for the new E/M codes.

ASHA members can stay informed and get involved!

ASHA is engaged in ongoing work to stop the cuts, as described below. We also need the collective voice of audiologists and SLPs to urge your members of Congress to stop the Medicare Part B payment cuts.

Clinicians can also stay informed by signing up for ASHA’s Headlines and Take Action e-mail lists, and by following ASHA Advocacy on Facebook and Twitter.

ASHA is actively working on this issue.

ASHA is dismayed by the scale of the negative impact, given that audiologists and SLPs cannot bill E/M codes to the Medicare program to help offset the proposed reductions in 2021. ASHA is engaged in ongoing advocacy and collaboration with CMS, key decision makers—including members of Congress—and other provider groups to stop the cuts.

ASHA’s Advocacy Highlights

  • Ongoing meetings with House and Senate members and staff as part of a broad coalition of physician and nonphysician groups urging Congress to waive the budget neutrality mandate to preserve payment increases for primary care services without the negative impact to other provider groups, including audiology and speech-language pathology.
    • ASHA’s congressional advocacy helped generate and facilitate a letter signed by 93 members of Congress [PDF] to House Speaker Nancy Pelosi and Republican Leader Kevin McCarthy urging that budget neutrality be waived to stop the cuts for two years while a longer-term solution can be developed. (August 11, 2020)
    • Congressional advocacy prompted a letter signed by 46 members of Congress [PDF] to House Speaker Nancy Pelosi urging that future legislation include provisions to stop the cuts. (May 28, 2020)
  • Following confirmation of the proposed cuts in the release of the 2021 Medicare Physician Fee Schedule proposed rule, issued joint statements with the American Occupational Therapy Association and the American Physical Therapy Association and a broad coalition of physician and nonphysician groups urging Congress to waive the budget neutrality requirement and stop the cuts. (August 4, 2020)
  • Signed on to multiple physician and nonphysician coalition letters calling on CMS or Congress to waive the budget neutrality requirement, allowing for increased primary care payments without the corresponding reductions to audiology and speech-language pathology services.
  • Wrote letters from ASHA's President to Senate [PDF] and House of Representatives [PDF] Leaders urging Congress to suspend the budget neutrality requirement for the MPFS related to the increase in E/M codes. (April 6, 2020)
  • Spearheaded a joint letter to CMS [PDF] from a group of 13 specialty societies and professional associations. The letter expresses our concerns regarding the proposed cuts and recommends potential regulatory strategies to mitigate the negative impact of the cuts. (February 10, 2020)
  • Wrote a letter from ASHA’s President to CMS [PDF], on behalf of ASHA members, to reiterate our concern regarding the negative impact on audiologists and SLPs, recommend regulatory strategies to address the cuts, and request specific impact data for SLPs. (February 10, 2020)
  • Worked with a large group of other specialty societies and professional associations to develop a letter to CMS signed by 99 members of the House of Representatives [PDF]. The letter registers the members’ collective concern with CMS’s proposed payment cuts, requests that the agency provide more data regarding how the cuts were determined, and asks what might be done to reduce their impact. (February 5, 2020)
  • Met with CMS as part of a group of 11 specialty societies and professional associations to discuss how CMS arrived at the projected reductions and share our concerns regarding the significant negative impact to many Medicare Part B provider groups who seldom or never report E/M services under the MPFS. (January 13, 2020)
  • Submitted comments to CMS in response to the 2020 MPFS proposed rule [PDF]. The comments included ASHA’s concern regarding the projected negative impact on audiologists and SLPs, and requested additional data from CMS to support the projections and explain how and why some specialties that do not bill E/M services under the Medicare benefit are most affected. (September 27, 2019)

Need more information?

ASHA members can contact reimbursement@asha.org for questions about Medicare payments or grassroots@asha.org for ways to get involved in ASHA’s advocacy initiatives with Congress.

Current procedure code values and national Medicare payment rates are available on ASHA’s Medicare Fee Schedule website.

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