Cover Page-2The Impact of the 2021 Medicare Physician Fee Schedule

on Physician Practice Revenue and Provider Compensation

The Centers for Medicare & Medicaid Services (“CMS”) periodically reviews CPT codes to identify, and correct, potentially mis-valued codes and related policies that drive healthcare payment rates.1 While in most years, this review results in nominal changes across the healthcare industry, the 2021 CMS Physician Fee Schedule Final Rule (“Final Rule”) is poised to drive a major shift in the way healthcare costs are valued and how reimbursement is administered.

Understanding these changes are critical to proper financial planning and to appropriately valuing physician compensation. As healthcare leaders know, properly compensating physicians is key to alignment, care coordination and compliance. The following sections briefly describe the key changes outlined in the Final Rule and how to tackle existing and prospective physician compensation agreements under the new standards.

  • Summary of Key Changes

  • Practice Reimbursement Implications

  • Considerations for Existing Provider Employment Agreements

  • Impact on Hospital-Based Coverage Arrangements