Updated 2021 Part B Fee Schedule

Confirming this year's Part B Fee Schedule was quite the waiting game with the last minute flurry from CMS. We have pulled together the attached location-specific Part B Fee Schedule tool. On the attached document, select “Enable Editing” (at the top), and input your location zip code. The tool will then populate your specific Fee Schedule.

2021 Part B Rates
Download XLSX • 3.10MB

The below clarifying points are taken directly from CMS.gov (https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched)

Updated Part B Physician Fee Schedule - CY 2021

Dec 27th, the Consolidated Appropriations Act, 2021 modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS) with the below updates:

  • Provided a 3.75% increase in MPFS payments for CY 2021

  • Suspended the 2% payment adjustment (sequestration) through March 31, 2021

  • Reinstated the 1.0 floor on the work Geographic Practice Cost Index through CY 2023

  • Delayed implementation of the inherent complexity add-on code from evaluation and management services (G2211) until CY 2024

CMS has recalculated the MPFS payment rates and conversion factor to reflect these changes. The revised MPFS conversion factor for CY 2021 is 34.8931. The revised payment rates are available in the 'Downloads' section of the CY 2021 Physician Fee Schedule final rule (CMS-1734-F) webpage.

CMS states they are processing payments timely.

Let's Get to the Point:

Sharing this rate schedule to provide another avenue to ensure corrected rates are loaded into your billing system to capture accurate reimbursement.