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Medicare Provisions in the 2021 Consolidated Appropriations Act

​President Trump signed the 2021 Consolidated Appropriations Act on December 27, 2020 after it was passed by Congress. The bill includes $1.4 trillion in funding for Federal Fiscal Year 2021 as well as several important updates to the Medicare program.

The legislation lifts the cap on Medicare-funded physician residency positions in teaching hospitals by 1,000 in fiscal year 2023. It lifts the cap by 200 positions each year until the slots are filled. The provision is based on the Resident Physician Shortage Reduction Act of 2019. The legislation also amends the Medicare GME Rural Training Tracks program to provide greater flexibility for rural and urban hospitals that participate in RTT programs.

The legislation also places a moratorium on payment under the Medicare Physician Fee Schedule for the Add on Code for Inherently Complex Evaluation and Management Visits. Payment is frozen until 2024 for the code. The code was finalized in the calendar year (CY) 2020 Physician Fee Schedule (PFS) final rule but was recently modified in the CY2021 PFS final rule.

The legislation also freezes the current payment and patient count thresholds for physicians and other eligible clinicians to qualify for the 5% advanced Alternative Payment Model (APM) bonus payment in payment years 2023 and 2024. It also freezes the partial qualifying APM participant threshold and patient count at current levels for performance years 2021 and 2022.

Congress also expanded Medicare access to mental health services delivered via telehealth by waiving the geographic and originating site requirements for mental health services delivered via telehealth. This will allow Medicare beneficiaries to receive mental health services in their homes and in any area of the country via telehealth. To be eligible, beneficiaries will be required to receive at least one in-person mental health service during the six months prior to the first telehealth service. The Center for Medicare and Medicaid Services may develop additional in-person requirements.

An AHA Special Bulletin on the Health Provisions in the Consolidated Appropriations Act, 2021 is available here.

The full text of the legislation is available here.

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