SCAI Highlights 2021 Medicare Payment Changes for Interventional Cardiology Procedures

December 8, 2020—The Society for Cardiovascular Angiography and Interventions (SCAI) announced that payments for the most common interventional cardiology procedures are dropping 9% in the Centers for Medicare and Medicaid Services’ (CMS) Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for CY2021. Additionally, SCAI noted that CMS is increasing payments for evaluation and management (E&M) services, but it is cutting most other services by 10.2% to maintain budget neutrality.

The SCAI announcement outlined the 2021 Medicare fee changes for the nine top interventional cardiology procedures. CMS’s press release on the new rule is available online here.

The society cautioned that approximately half of interventional cardiologists have not updated their CMS specialty code from general cardiology to interventional cardiology.

In the press release, SCAI advised that it was successful in getting new codes paid for 2021. Sergio Bartakian, MD, led the effort to get new codes for atrial septostomy (CPT codes 33741, 33745, 33746) and getting appropriate reimbursement rates for them as well. SCAI will have a webinar on these new congenital codes in early January 2021. New codes were also developed for percutaneous ventricular assist devices.

According to SCAI, interventional cardiologists provide many E&M services along with interventions and it is critical that members and their coders learn the revised and new E&M codes.

The society also noted that documentation requirements for many E&M services have been relaxed or eliminated. In addition, there are new add-on E&M codes for complex patients (G2211) and prolonged services (G2212). CMS estimates that interventional cardiologists will use these new add-on codes > 200,000 times in 2021.

Finally, the announcement provides links to sources of guidance on the E&M coding from CMS, the American Medical Association, and the American College of Cardiology’s Medaxiom. Physicians and their staff need to adapt to these changes, which will significantly offset the procedures cuts, stated SCAI.