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Payment cuts, new conversion factors, a temporary lift of sequestration reductions, and more: The Medicare payment world changed dramatically in 2021. APTA's members-only Medicare physician fee schedule calculator can help you navigate the new landscape.

This year's calculator includes the recently revised conversion factor and incorporates the 50% multiple procedure payment reduction as well as the overall 2% cut to Medicare payments implemented through sequestration. Users also can calculate the payment amount without sequestration for dates of service Jan. 1 to March 31, 2021, due to the temporary suspension of sequestration.

The calculator, delivered by way of an Excel spreadsheet, calculates Medicare physician fee schedule payment for procedures provided to a beneficiary on a given day in a specific geographic location.

Other features include options for selecting your Medicare participation status — participating, nonparticipating but accepting assignment, or nonparticipating and not accepting assignment — as well as the ability to compare the 2021 payment rate with the rate in 2020. The calculator also features a Merit-based Incentive Payment System adjustment tool, another new facet of the 2021 payment year.


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