On Dec. 27, 2020, President Donald J. Trump signed the Consolidated Appropriations Act, 2021 (H.R.
133) into law (P.L. 116-260) — a massive omnibus spending bill that includes nearly $900 billion for
coronavirus relief and an additional $1.4 trillion spending package to fund the federal government
through the end of the Fiscal Year 2021. The measure incorporates several priorities of the American
Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS).
Provisions of interest to neurosurgeons are detailed below.
Medicare Payment Provisions
Background
Substantial changes in how neurosurgeons report office and outpatient evaluation and management
(E/M) clinic visits were implemented beginning on Jan. 1, 2021. Under the new system, CPT code 99201
was eliminated, and changes were made to the remaining codes for new patient visits (CPT codes 99202
to 99205) and established patient visits (CPT codes 99211 to 99215) — including the values of each code.
Unfortunately, despite nearly uniform agreement among the medical community, CMS refused to adjust
the E/M portion of the 10- and 90-day global surgery codes to account for the increased values of the
stand-alone E/M codes. Thus, the value of neurosurgical procedures will not increase. Furthermore, CMS
proposed a new add-on code — G2211 (formerly GPC1X) — for complexity inherent to E/M services that
will commonly be reported only by specific subspecialties, not including neurosurgery.
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