CMS Releases 2021 Medicare Physician Fee Schedule; ABA Codes Remain Carrier-Priced

December 29, 2020

The Centers for Medicare & Medicaid Services (CMS) released the FINAL 2021 Medicare Physician Fee Schedule (MPFS) rule on December 1st. It can be found here. Addendum B, which contains all assigned relative value units (RVUs) for services within the MPFS, clearly indicates that the CPT codes for adaptive behavior (ABA) services (97151-97158, 0362T, 0373T) will remain carrier-priced (denoted by “C” in the status column in Addendum B). That means those codes have not been assigned RVUs and will continue to be carrier-priced in 2021.