24 Surgical Organizations Urge CMS to Reconsider Global Codes Policies

WASHINGTON, July 29, 2021 – The members of the Surgical Care Coalition joined more than 20 surgical organizations signing a letter urging the Centers for Medicare & Medicaid Services (CMS) to reassess changes to bundled surgical services—global codes—in the Medicare Physician Fee Schedule (MPFS) for calendar year 2022 that double down on cuts to surgical care, harming patient access to critical treatments and procedures by prioritizing specialties.

Physician organizations encouraged CMS to apply the American Medical Association/Specialty Society Relative Value Scale Update Committee’s (RUC) recommendations that would apply the increased office/outpatient visit E/M code values to all the 10- and 90-day global surgical package codes, ensuring equal payment to physician specialties for the same medical service. The RUC is a group of 32 physicians and more than 300 medical advisors, other healthcare professionals, and national specialty society experts that represent each sector of medicine, who actively uses data to make recommendations to CMS.

“Once again CMS failed to increase payments for needed follow-up office visits after complex surgery, such as a colectomy,” said David B. Hoyt, MD, FACS, American College of Surgeons Executive Director. “With different payments by specialty for evaluation and management services—or office visits—CMS is pitting doctor against doctor and threatening patient care.”

The letter to CMS further argues that failure to apply the RUC recommendations disrupts the relativity in the fee schedule, creating specialty differentials by paying physicians differently for the same work, and ignores recommendations endorsed by nearly all medical specialties.

“It’s disappointing that CMS’s proposed 2022 fee schedule doesn’t make any mention of applying payment equity to post-operative visits included in the global surgical payment, even after strong advocacy from the surgical community,” said George A. Williams, MD, American Academy of Ophthalmology Senior Secretary for Advocacy. “To mitigate the cuts proposed for 2022, we need to ramp up our efforts to push CMS to apply the increased payment for evaluation and management to post-operative visits in the global period and to prevent cuts delayed by the 2021 pandemic relief.”

While Congress took action last year to stop other cuts to surgical care, it failed to address these needed payment increases to post-operative office visits for bundled surgical services. The proposed 2022 MPFS released in mid-July also included a 3.75% cut to the Medicare conversion factor, reinstating a cut that Congress prevented last year. Without congressional intervention, these cuts to surgical care will be devastating to Medicare patients and their ability to access quality surgical care.

Read the full letter here.

About the Surgical Care Coalition

The Surgical Care Coalition advocates for access to quality surgical care for all Americans. The Surgical Care Coalition is comprised of 13 surgical professional associations that proudly represent the more than 150,000 surgeons working across the country with a common goal of improving the quality of care, and quality of life, for all patients.