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Breaking News: Medicare proposes slashing chiropractor compensation

Chiropractic Economics October 6, 2020

The Center for Medicare and Medicaid has published a proposed rule for calendar year 2021 which could decrease compensation for chiropractors as much as 19% according to the International Chiropractors Association.

“The ICA has grave concerns about the proposed rule which are outlined herein,” the ICA stated in a press release. “We urge the rejection of the rule as proposed given its unequal treatment of doctors of chiropractic which will result in a 19% decrease in compensation. We further request CMS create parity in the compensation by increasing the RVUs for spinal manipulation to address the E/M components of that service while implementing the stated purpose of the rule. The ICA calls for a rejection of decreases for the specific CPT codes 98940, 98941, and 98942.”

The ICA also suggested a moratorium on any reductions in compensation in Medicare for any profession while the nation’s health care providers continue to provide care during the global COVID-19 pandemic.

“The CMS Calendar Year 2021 Changes to Physician’s Fee Schedule proposed rule is draconian, undermines the nation’s response to the opioid addiction crisis, and increases rather than decreases the disparity in the federal treatment of integrative health professionals such as doctors of chiropractic,” said ICA President Stephen Welsh, DC.

Under current rules, doctors of chiropractic are not able to seek reimbursement for other standard of care services provided to Medicare beneficiaries in the course of normal care such as exams and x-rays.

“Most chiropractors in the United States are small business owners, not part of corporate health systems or hospital-based practices,” the ICA statement says. “The combined impact of reductions to the work RVU (-7%) and the practice expense RVU (-3%) for chiropractors will mean a total decrease of 10%…The combined effect of reduced RVUs, reduced conversion factor and lack of payment for E/M codes results in an actual payment decrease of over 19%.”

In a time of increased U.S. government-provided access to non-drug care in the midst of an opioid and COVID-19 crisis, the proposed decrease would further hinder the ability of Medicare beneficiaries across the nation to access needed non-drug services.

“While doctors of medicine and doctors of osteopathy are paid for E/M codes and will see increases in reimbursement due to increases in RVUS with these codes, doctors of chiropractic will not, but will be burdened with a reduction in compensation,” the ICA states. “ICA requests instead that CMS address the disparity and increase the RVUs for spinal manipulation to address the E/M components.”

To read the full ICA release go to https://files.constantcontact.com/a75bb7a5301/a836bda0-9b22-4f40-ab07-c6e4cc24c7b1.pdf.

The ICA adds, “What Can You Do? Members of Congress Are Increasingly Using Social Media – Facebook and Twitter. Please Reach out to Your 2 Senators, Share our Message. Don’t know your Senators – visit the Senate Website – Ask they Call Upon CMS to suspend any reductions in Calendar Year 2021.”

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