CMS is proposing a significant shift in payments from procedures and to evaluation and management services for 2021. If implemented, fees for most procedures will drop about 9% while payments for evaluation and management services will increase by up to 14%. A chart showing how the top 10 services provided by interventional cardiologists may be affected if the proposal is implemented. SCAI is already working with a coalition to have Congress override the reductions for procedures.

Under this proposal, cardiac surgeon’s average fees will go down 10% and family practice’s will go up 13%.

CMS also responded to the AMA’s Relative Value Committee’s (RUC’s) recommendations on the work values for new/revised and reviewed codes. Only 75% of the RUC’s recommendations were accepted and CMS reduced the values for most of the rejected recommendations. In interventional cardiology, CMS is proposing to:

Accept the recommendations for:

  • Atrial Septostomy (p. 245)
  • Percutaneous Ventricular Assist Device (PVAD) Insertion (p. 247)

Lower the recommendations for:

  • Intracardiac Echocardiography (ECG) (p. 280)
  • Ventricular Assist Device (VAD) Interrogation (CPT code 93750) (p. 281)

For Transcatheter intracardiac shunts (TIS) (p. 246 & 313) CMS accepted one value and is proposing to reduce another.

CMS is proposing to remove 11 National Coverage Decisions (NCD) that appear to be outdated/unnecessary (p. 526). Unfortunately, this list does not include the antiquated pulmonary embolism coverage policy that is nearly 40 years old. SCAI will reiterate its objection that NCD (240.6) needs to be removed to ensure that facilities will make newer pulmonary embolism procedures available to physicians and their patients.