Proposed Medicare Cuts Threaten Anesthesiology Practices

The Centers for Medicare & Medicaid Services (CMS) has proposed cuts to the Medicare fee schedules for anesthesia services that could return payment rates for anesthesiologists to levels last seen nearly 30 years ago.

Each year, CMS proposes updates to its Medicare Physician Fee Schedule. The proposed 2021 physician payment schedule includes several increases, including a significant rise in payment for office visits.

However, due to a congressional budget neutrality requirement, any increases in the fee schedule must be offset so the total remains budget-neutral within a range of $20 million. Anesthesia-related services have been targeted with cuts to meet that requirement.

For anesthesiologists, this change means a new conversion factor for many services will result in payment at lower rates. For example, the 2021 proposed anesthesia conversion factor of $19.9631 is practically the same as the 1991 counterpart of $19.27. The proposed resource-based relative value scale (RBRVS) conversion factor of $32.2605 is $4 less than the 1998 one of $36.6873, the first year that CMS established a single RBRVS conversion factor.