Important Information About the 2021 Physician Fee Schedule Final Rule

2021 Physician Fee Schedule Final Rule

CMS posted the 2021 Physician Fee Schedule Final Rule which includes updates to the MSSP and QPP programs.

On December 2, the Centers for Medicare & Medicaid Services (CMS) published the 2021 Physician Fee Schedule Final Rule (PFS).  Besides updating the fee schedule, this rule providers updates to several areas of CMS regulations, including the Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACO) and Quality Payment Program (QPP).

What happened?

  • CMS posted the calendar year 2021 PFS Final Rule which includes updates to the MSSP and QPP programs.
  • CMS finalized its proposal to integrate the quality measures of the MSSP ACOs with the QPP Merit-based Incentive Payment System (MIPS) program to better align the two.

Why is it important?

  • CMS finalized its intention to retire the current mechanism MSSP ACOs use to report quality measures by 2022.
  • CMS is allowing MSSP ACOs to choose their mechanism of reporting quality for 2021.  This is being considered a transition year.

How does this impact you?

  • Those participating in an MSSP ACO must carefully consider how to move forward with reporting requirements for the program.  With the sunset of the CMS Web Interface, ACOs must rely on EHR data to accurately collect and submit quality data for the ACO.
  • Although through this change the number of quality measures has decreased, ACOs must now look at implementing changes across all payers, as the reporting mechanisms under MIPS include all payers, not just ACO Medicare beneficiaries.