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January 2022

Medicare sequestration suspension extended through March 31, 2022

As you may recall, Blue Cross Blue Shield of Michigan and Blue Care Network aligned with the Centers for Medicare & Medicaid Services’ guidance when Congress and the Biden administration suspended the mandatory Medicare 2% sequestration reduction through the end of 2021.

Congress passed legislation on Dec. 9, 2021, that suspends the 2% sequestration reduction through March 31, 2022, and then reduces the sequestration cuts to 1% from April through June 2022. We’ll update you before July 2022 on the status of sequestration after June 30, 2022.

Reminder: The 2% reimbursement adjustment is applied after determining any applicable member deductible, copayment or other required member out-of-pocket costs. The change won’t affect reimbursement to providers who haven’t been affected by sequestration previously, such as providers of durable medical equipment, lab services providers and providers treating patients with end-stage renal disease.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2021 American Medical Association. All rights reserved.