CHEST and ATS Respond to Proposed Fee Schedule

OCTOBER 2020

CHEST and ATS Respond to Proposed Fee Schedule

CHEST and the American Thoracic Society (ATS) submitted joint comments regarding the proposed Medicare Physician Fee Schedule for 2021 to CMS Administrator Seema Verma on topics of direct interest to members. The letter focuses on:

• Medicare payment for critical care services: Further to the joint letter from CHEST, ATS, and the Society of Critical Care Medicine to Department of Health and Human Services Secretary Azar (see article in September 2020 Washington Watchline), the concerns related to the proposed 8% reduction in reimbursement for critical care services are explained, particularly relating to the role of critical care providers during the pandemic. They call for waiving budget neutrality or utilizing the public health emergency declaration to ensure appropriate patient care.
• E/M payment changes: ATS and CHEST voice support for the proposed changes to evaluation and management (E/M) office visits and the increased reimbursement for the cognitive component of E/M medicine. They urge CMS to use its authority to waive the budget neutrality requirements while implementing the E/M changes.
• Adoption of RUC-recommended values for pulmonary services: They urge CMS to finalize values for specific pulmonary services while acknowledging thanks for the adoption of the Relative Value Scale Update Committee (RUC)-recommended physician work values for a range of Current Procedural Terminology codes.
• Telehealth services: While commending CMS for actions related to telehealth to provide care during the pandemic, they suggest it is now appropriate to sunset the telehealth listing for critical care services as providers have acquired additional experience in treating COVID-19.
• GPC1X descriptors and utilization projections: They urge CMS to clarify the descriptors and seek additional comments on primary and ongoing health-care services.

Watch for reports of ongoing efforts from CHEST as the fee schedule process continues. Details of other activities in support of CHEST members will appear in the November issue of Washington Watchline.

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