CMS Extends PHE for Another 90 Days

Original story posted on: April 19, 2021

CMS also suspended Medicare’s FFS claims payment adjustment through December.

The Centers for Medicare & Medicaid Services (CMS) announced that the suspended sequestration payment adjustment of 2 percent –  which applied to all Medicare Fee-for-Service (FFS) claims from May 1 through Dec. 31, 2020, later extended through March 21, 2021 by the Consolidated Appropriations Act –  has been again extended through the end of 2021. The announcement was made April 16.

An Act to Prevent Across-the-Board Direct Spending Cuts, and for Other Purposes, signed into law on April 14, extends the suspension period to Dec. 31, 2021.

Medicare Administrative Contractors (MACs) will now:

  • Release any previously held claims with dates of service on or after April 1
  • Reprocess any claims paid with the reduction applied

Practices are told that they do not need to take any action.

Another regulation to keep an eye on is the formal extension of the federal public health emergency (PHE). The current PHE declaration was extended on April 15, and will now be set to expire on July 20. The Biden Administration has indicated that the PHE will likely remain in place throughout 2021, and that states will receive 60 days’ notice before the end of the PHE to prepare for the end of emergency authorities and the resumption of pre-PHE rules.

To continue to monitor the PHE status you go online to this link and review the U.S. Department of Health and Human Services (HHS) current policy:


Terry Fletcher, BS, CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, QMGC, QMCRC, is a healthcare coding consultant, educator, and auditor with more than 30 years of experience. Terry is a past member of the national advisory board for AAPC, past chair of the AAPCCA, and an AAPC national and regional conference educator. Terry is the author of several coding and reimbursement publications, as well as a practice auditor for multiple specialty practices around the country. Her coding and reimbursement specialties include cardiology, peripheral cardiology, gastroenterology, E&M auditing, orthopedics, general surgery, neurology, interventional radiology, and telehealth/telemedicine. Terry is a member of the ICD10monitor editorial board and a popular panelist on Talk Ten Tuesdays.


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