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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 fight the cuts.

Ask your U.S. Representative to support H.R. 8702, the Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020! 

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

In its release of the 2021 Medicare Physician Fee Schedule (MPFS), the Centers for Medicare & Medicaid Services (CMS) implemented a 6% decrease in payment for audiology services and a 9% decrease for speech-language pathology services. Audiologists and SLPs are not the only providers seeing significant payment reductions in 2021. For example, other decreases include 8% for cardiac surgeons, 10% for chiropractors, and 10% for radiologists, among others.

ASHA submitted formal comments on the proposed rule to CMS as part of the public comment period. However, CMS did not substantially respond to comments regarding the proposed payment cuts, which will be implemented on January 1, 2021, absent Congressional action. Clinicians should be prepared for the cuts to go into effect on January 1 in the event Congress does not pass H.R. 8702, the Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020, or another similar legislative fix before the end of the year. If congressional action occurs after the new year, ASHA expects any solutions to address the cuts will likely be retroactive to 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!

A new bill to address the cuts has been introduced in the U.S. House of Representatives. H.R. 8702, the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020, would help address these cuts by providing relief payments to audiologists and SLPs in an amount that will ensure parity with current payment for impacted services for the next two years until a longer-term solution is developed. Please contact your U.S. Representative asking for their support!

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. Advocacy efforts are intensifying as the January 1, 2021, implementation approaches. However, clinicians should be prepared for the cuts to go into effect on January 1 in the event Congress does not pass H.R. 8702, the Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020, or another similar legislative fix before the end of the year. If congressional action occurs after the new year, ASHA expects any solutions to address the cuts will likely be retroactive to January 1, 2021.

ASHA’s Advocacy Highlights

Congressional Advocacy

ASHA engages in ongoing advocacy with House and Senate members and staff directly and as part of a broad coalition of physician and nonphysician groups urging Congress to seek solutions—such as waiving the budget neutrality mandate or holding affected providers harmless—to preserve payment increases for primary care services without the negative impact to other provider groups, including audiology and speech-language pathology.  

Regulatory Advocacy

ASHA engages in ongoing advocacy with CMS and the Department of Health and Human Services (HHS) directly and as part of a broad coalition of physician and nonphysician groups to find regulatory solutions to preserve payment increases for primary care services without the negative impact to other provider groups, including audiology and speech-language pathology.

  • Submitted comments to CMS in response to the 2021 MPFS proposed rule [PDF]. The comments included ASHA's concerns regarding the substantial negative impact of the cuts on audiologists, SLPs, and the Medicare beneficiaries they serve and offered potential strategies for CMS to mitigate or stop the cuts.
  • Following confirmation of the proposed cuts in the release of the 2021 Medicare Physician Fee Schedule proposed rule, ASHA, the American Occupational Therapy Association, and the American Physical Therapy Association met with CMS to express our continued concerns [PDF] regarding the negative impact of the cuts and offer potential regulatory solutions to mitigate or stop the cuts. (September 29, 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)
  • 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)
  • Signed on to coalition letters calling on CMS to find regulatory strategies to mitigate or stop the payment cuts.
    • Coalition comment letter from 45 physician and nonphysician groups [PDF] in response to the 2021 MPFS proposed rule offering potential regulatory strategies to mitigate or stop the payment cuts. (October 5, 2020)
    • American Medical Association letter from 102 physician and nonphysician groups [PDF] calling on CMS to use its authority under the public health emergency to waive the budget neutrality requirement. (July 1, 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)

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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