In January 2022, physician practices face the following Medicare financial hits:
1. The expiration of the congressionally enacted 3.75% temporary increase to the Medicare physician fee schedule conversion factor, which was set into place to avoid payment cuts associated with budget neutrality adjustment tied to PFS policy changes.
2. The expiration of the current reprieve from the repeatedly extended 2% sequester stemming from the Budget Control Act of 2011. It appears that while Congress originally scheduled this policy to sunset in 2021, it will now continue into 2030.
CMS is also eliminating coverage for telephone only services (CPT 99441-99443), effective December 20, 2021. Consequently, this will affect access to Medicare patients, rural patients, and many others with special circumstances.
All the financial uncertainty comes at a time when physician practices and facilities are still suffering from the financial impact of the COVID-19 public health emergency, including continued infection control protocols, that while necessary, have increased costs of provider care. In addition to this, the Delta insurgence has created numerous new problems with a reduced patient load and increased practice costs. We continue to face 20% to 25% reductions in patient revenue, while costs have escalated by 20% to 25%, with a net result of 40% reductions. No practice can sustain this. This will stretch physician practices to their limits finically, clinically, and emotionally. The reality is, as the pandemic persists and continues, it is unknown what other variants will continue attacking us. Overall, Medicare physician payments actually declined 22% from 2001 to 2020, or by 1.3% per year on average.