Medicare Physician Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) uses the Medicare Physician Fee Schedule (MPFS) to reimburse physician services. The MPFS is funded by Part B and is composed of resource costs associated with physician work, practice expense and professional liability insurance.

Under the MPFS, each of these three elements is assigned a Relative Value Unit (RVU) for each Current Procedural Terminology (CPT®) code. These RVUs are then adjusted based on the Geographical Practice Cost Index associated with various geographic areas for different medical costs and wage differentials. The conversion factor is the national dollar amount that is multiplied by the total geographically adjusted RVU to determine the Medicare-allowed payment amount for a particular physician service.

 

2021 Medicare Physician Fee Schedule


CR staff have prepared a detailed summary of the 2021 proposed and final rules as well as impact tables to show the specific changes in reimbursement rates between 2020 and 2021 for each CPT code.

Summary of 2021 Final Rule
Summary of 2021 Proposed Rule
Impacts for 70,000 Series CPT Codes
Impacts for non-70,000 Series CPT Codes
2021 Proposed Rule Comment Letter
2021 Final Rule Comment Letter