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CMS Extends Sequestration through the end of Calendar Year 2021

The Centers for Medicare & Medicaid Services (CMS) announced that the moratorium on the 2% Sequestration payment reduction has been extended through December 31, 2021.  CMS noted the following in a MedLearn Matters (2021-04-16-MLNC):

The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the sequestration payment adjustment percentage of 2% applied to all Medicare Fee-for-Service (FFS) claims from May 1 through December 31, 2020.  The Consolidated Appropriations Act, 2021, extended the suspension period to March 31, 2021. An Act to Prevent Across-the-Board Direct Spending Cuts, and for Other Purposes, signed into law on April 14, 2021, extends the suspension period to December 31, 2021.

Medicare Administrative Contractors will:

  • Release any previously held claims with dates of service on or after April 1
  • Reprocess any claims paid with the reduction applied

You don’t need to take any action. 

Practices should not see any of these automatic reductions on claims and as noted above, adjustments to reverse the improper reductions should be automatic.  If, in the unusual situation you have not had claims adjusted for this, please contact Provider Services at your local Medicare Administrative Contractor.

We are available and happy to assist you with issues related to eye care coding and reimbursement.  We are still giving our webinars related to the significant changes for 2021 Evaluation and Management eye exam coding.  Our 2021 EM full program includes a large, completely revised text and new Office Visit Guide pocket guides.  We also have new webinars available to help you document these new E/M services as well as internally audit the 2021 E/M and Eye coding, so contact us if you are interested.  Stay safe.

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