CMS' proposed 2021 fee schedule could spell trouble for anesthesia, according to a report from Anesthesia Business Consultants.
Five things to know:
1. CMS set the national Medicare physician fee schedule conversion factor at $32.26, a $3.83 decline from 2020. The calculation will be used to figure anesthesiologist and anesthesia payment for surgical services including postoperative pain blocks and invasive line placements, according to the report.
2. The proposed 2021 national anesthesia conversion factor is $19.96, according to the American Society of Anesthesiologists, a significant drop from the $22.20 in 2020. The ASA is advocating for the rate to increase in the final rule.
3. CMS proposed adding more telehealth services to the Medicare telehealth list on a Category 1 basis in 2021 and proposed allowing direct supervision to be provided with interactive, real-time audio and video technology through Dec. 31, 2021.
4. In the 2021 proposed rule, CMS allows nurse practitioners, clinical nurse specialists, physician assistants and certified nurse-midwives to supervise diagnostic tests within their scope of practice if state law allows, as long as they have required statutory relationships with supervising or collaborating physicians, according to the ABC report.
5. The proposed rule allows teaching physicians to communicate with residents virtually as being "present" for portions of service, but the virtual supervision may not extend to anesthesiology. The rule states that because a patient's clinical status can change quickly during surgery or anesthesia procedures, the agency believes personal oversight is necessary.