Following 6 months of intensive efforts with Members of Congress and the Administration, SCAI Government Relations Committee Chair, Lyndon Box, MD, FSCAI and Co-Chair, Joaquin Cigarroa, MD, FSCAI believe relief is on the way to SCAI members. The following is a brief summary of “E&M Fix” provisions contained in the end-of-year package Congress passed this week:

• A delay of G2211 CPT code for three years, aimed at mitigating the proposed Conversion Factor cuts by a projected one-third overall.
• $3 billion in new money put into the physician fee schedule in 2021, resulting in an across the board payment increase helping all Medicare providers during the ongoing COVID-19 pandemic (Note: The bill allows the Secretary of Health and Human Services broad discretion making it unclear how exactly this would be accomplished).
• A 3-month delay of the 2 percent sequester cuts that were set to resume January 1, 2021.

While some details remain unclear (as noted above), the bill would reverse the Medicare cuts found in the Centers for Medicare and Medicaid Services (CMS) Final Rule on the Physician Fee Schedule for FY 2021. Presuming that the conversion factor will be used by the Secretary to incorporate the new funding of 3.75 percent, SCAI members would be projected to see a 0.3% percent average increase in fees from Medicare patients and while most procedures had been scheduled for a 9% cut will now see about 5% cuts. 

According to a House Ways and Means Committee summary of the legislation, these policies will substantially mitigate the cuts to certain providers that were due to Medicare budget neutrality requirements. Congress passed the final package late on Monday, December 21, 2020. The President has not definitively said whether he will sign the Omnibus package and has more recently expressed some reservations about the legislation. A more detailed and updated analysis of the bill’s provisions is forthcoming.