Update to Medicare Deductible, Coinsurance and Premium Rates for CY 2021

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

On November 20, 2020, CMS posted Transmittal 10469 for Medicare contractors to update the claims processing system with the new Calendar Year (CY) 2021 Medicare rates. This Recurring Update applies to Chapter 3, Sections 10.3, 20.2 and 20.6 of the Medicare General Information, Eligibility, and Entitlement manual.

2021 PART A – HOSPITAL INSURANCE (HI)

Part A Deductible

• $1,484.00

Part A Coinsurance

  • $371.00 a day for 61st-90th day
  • $742.00 a day for 91st-150th day (lifetime reserve days)
  • $185.50 a day for 21st-100th day (Skilled Nursing Facility (SNF) coinsurance)

PART B – SUPPLEMENTARY MEDICAL INSURANCE (SMI)

Part B Standard Premium

  • $148.50 a month

Part B Deductible

  • $203.00 a year

Pro Rata Data Amount

  • $145.31 1st month
  • $57.69 2nd month

Coinsurance

  • 20 percent

Please share this update with your billers as there is additional information in the CR.