NOTE: Below is legislation from the 116th Congress. ASHA is working on introducing similar legislation for 117th Congress.
Take Action
Stop Medicare payment reductions for audiology, speech-language pathology, and other critical specialty health care providers to offset payment increases for primary care services.
Professionals: Email your members of Congress today!
Download the Issue Brief [PDF] to learn more.
The Issue
Medicare payment increases for primary care providers would result in lower payments for outpatient services provided by audiologists, speech-language pathologists (SLPs), and other physician and nonphysician providers of critical specialty health care services. Ask your federal representatives to cosponsor the Holding Providers Harmless From Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702/S. 5007), which would provide relief payments to hold impacted providers harmless from the impact of the cuts scheduled for implementation in January 2021. This will allow the Centers for Medicare & Medicaid Services (CMS) to provide needed increases in payments to providers that bill E/M codes without having to implement cuts to audiologists, SLPs, and other specialty service providers.
The Details
- In the 2021 MPFS final rule, CMS implemented changes to office/outpatient Evaluation and Management (E/M) procedure codes that will result in payment increases for primary care services beginning in 2021.
- As mandated by law, CMS must ensure the total values for all procedure codes paid under the MPFS remain budget neutral.
- Payment reductions necessary to maintain budget neutrality will impact multiple specialty health care providers and are higher than usual because of the significant increase in value for the new E/M codes.
- CMS is implementing a 6% decrease in payment for audiology services and a 9% decrease in payment for speech-language pathology services.
- Audiologists and SLPs cannot bill E/M codes under the Medicare program to help offset the proposed reductions.
- Since the law requires budget neutrality under the MPFS, CMS has limited latitude to increase payments to primary care providers without reducing reimbursement for other services.
- Recently, 229 members of the House of Representatives wrote to Speaker Nancy Pelosi and Republican Leader Kevin McCarthy urging them to pass a bipartisan solution to this problem. Recently, 50 Senators wrote Senate leaders urging immediate action.
- Audiologists and SLPs who rely on reimbursement from Medicare cannot withstand the losses in revenue from reduced Medicare payments on top of COVID-19 related financial losses.
