Take Action
Stop Medicare payment reductions for audiology, speech-language pathology, and other specialty critical 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 members of Congress to suspend the budget neutrality requirement for the Medicare Physician Fee Schedule (MPFS) related to the increase in reimbursement for E/M codes scheduled for implementation in 2021. Suspending the budget neutrality requirement 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 devastating cuts to audiologists, SLPs, and other specialty service providers.
The Details
- In the 2020 MPFS, CMS proposed 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.
- Projected 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 projecting a 7% 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.
- Ninety-three members of the House of Representatives wrote to Speaker Nancy Pelosi urging that future legislation include provisions to stop these proposed cuts.
- Audiologists and SLPs in private practice who rely on reimbursement from Medicare cannot withstand the losses in revenue from reduced Medicare payments on top of COVID-19 related financial losses.
