On Aug. 3, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that includes updates to payment policies, payment rates and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective on or after Jan. 1, 2021. At the same time, the administration issued an Executive Order on Improving Rural and Telehealth Access. Here are a few takeaways from the 1,355-page rule.

• The proposed CY 2021 PFS conversion factor is $32.26, a significant decrease of $3.83 below the CY 2020 PFS conversion factor of $36.09 (11 percent decrease compared to last year).
• The federal CMS proposes to implement finalized CPT descriptors, guidelines and payment rates for evaluation and management (E/M) services on Jan. 1, 2021, which will be a significant modification to the coding, documentation, and payment of evaluation and management (E/M) services for office visits. While the agency recognized the increases in the payment bundles for maternity care and a few other select services, the visits within the 10-day and 90-day surgical global surgical payment bundle remains unchanged.
• The executive order and proposed rule aims to expand payment for telehealth for Medicare beneficiaries permanently, beyond the COVID-19 public health emergency.
• The federal CMS proposes to continue to gradually implement MIPS in 2021 and postpones the MIPS Value Pathways participation option until 2022 at the earliest.