August 12, 2020

Congressman Rush Requests E/M Budget Neutrality Waiver

Earlier this week, Congressman Bobby Rush (D-IL) and 92 of his House colleagues sent a bipartisan letter to House leadership asking for a two-year waiver of budget neutrality to be included in any relevant upcoming legislation to avert the impending reductions associated with implementing the Centers for Medicare and Medicaid Services (CMS) 2021 evaluation and management (E/M) policy. Congressman Rush’s letter also requested CMS report to Congress on the impact the reductions would have on patient access in underserved areas as well as the impact of the E/M policy if budget neutrality isn’t waived.

The 2020 Medicare Physician Fee Schedule rule finalized significant increases to E/M codes that are scheduled for implementation Jan. 1, 2021. Due to the required application of budget neutrality in the fee schedule, any code level increases must be offset by corresponding decreases, which will result in significant, across the board Medicare reimbursement reductions to specialties who do not frequently, if ever, bill E/M. Diagnostic radiology is currently facing an 11% across the board reduction, and interventional radiology is scheduled for a 9% reduction.

The American College of Radiology® (ACR®) has formed a coalition of more than 50 physician and non-physician providers, including the American Medical Association, asking Congress to waive budget neutrality so radiologists and others aren’t faced with reimbursement reductions, particularly as they navigate the current public health emergency.

The ACR will continue to urge Congress to act to avert the impending reductions.