Medicare Physician Fee Schedule
The Medicare Access and CHIP Reauthorization Act (MACRA) was signed in April 2015. This law:
- Repeals the Sustainable Growth Rate (SGR) methodology for determining updates to the Medicare physician fee schedule.
- Establishes annual positive or flat fee updates for 10 years and institutes a two-tracked fee update afterwards.
- Establishes a Merit-based Incentive Payment System that consolidates existing Medicare fee-for-service physician incentive programs.
- Establishes a pathway for physicians to participate in alternative payment models, including the patient-centered medical home.
- Makes other changes to existing Medicare physician payment statutes.
On November 1, 2019, the Centers for Medicare & Medicaid Services (CMS) released a final rule and interim final rule on the 2020 Medicare Physician Fee Schedule (MPFS). This regulation also impacts the Quality Payment Program (QPP). CMS released a related fact sheet and press release.
The final 2019 MPFS conversion factor is $36.0391. Reflecting the same values estimated in the proposed rule, the final 2020 MPFS conversion factor will be $36.0896. Based on CMS’ final rule, there would be no change in total Medicare allowed charges for family medicine in 2020, but total allowed charges for family medicine would increase 12% in 2021.
The AAFP commented on the 2020 proposal in a September 18, 2019 letter(61 page PDF).
Recent AAFP Communications
AAFP Initial Summary of the 2020 Final Medicare Physician Fee Schedule - November 1, 2019(3 page PDF)
AAFP Letter to Congress on 2020 Medicare Physician Fee Schedule Updates - October 31, 2019(3 page PDF)
AAFP Response to the 2020 Proposed Medicare Physician Fee Schedule - September 18, 2019(61 page PDF)
AAFP Initial Summary of the 2020 Proposed Medicare Physician Fee Schedule - July 30, 2019(4 page PDF)
AAFP Comment Letter on 2019 Final Medicare Physician Fee Schedule - December 28, 2018(12 page PDF)
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