Medicare rates were to have been reduced by about 10% for all services other than E&M codes. However, due to the recent senate and congressional voting funding additional monies to Medicare this cut was averted and will only be about 5-6% instead of 10%. Unfortunately, due to the late rulings within the last week of 2020 the updated fees are not yet published.

The deductible will be $203 for 2021 and for now any claims to Medicare bill at last year’s rates and when the claim is paid or adjudicated it will be done at the new rates. We are anticipating that the fees will be published within a week. Members, please check with Sam at the week’s end.

Beginning January 1, 2021, the U.S. Department of Veterans Affairs (VA) will phase in a new approach for its community care fee schedule payment rate calculations that better align VA to industry best practices.

Instead of rates being calculated based on the location of the referring VA medical center, rates will now be calculated based on the location of where the care is provided (i.e. rendering locality). This means that beginning January 1, 2021, payment rates under the VA fee schedule may be different from 2020.

VA generally reimburses hospital care, medical services, and extended services at the applicable Medicare rate published by the Centers for Medicare and Medicaid Services (CMS). When no CMS rate is available, VA and Third Party Administrators reimburse at the lesser amount of (1) billed charges or (2) the VA fee schedule rate. The VA fee schedule rate is the amount published for the designated date of the service time period.

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