CMS Releases Medicare Physician Fee Schedule Proposed Rule for 2024

California, U.S.- AUGUST 17, 2023- On 13th July, the Centers for Medicare & Medicaid Services (CMS) introduced the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS). The proposal suggests reducing the conversion factor by 3.34%, setting it at $32.75 for the calendar year 2024, as opposed to the value of $33.89 in CY 2023. This adjustment takes into account several factors: the conclusion of the 2.5% statutory payment increase for CY 2023, the implementation of a 1.25% statutory payment increase for 2024, no update to the conversion factor as per the Medicare Access and CHIP Reauthorization Act, and a budget-neutrality adjustment of -2.17%.

The Proposed Rule encompasses a range of health equity-focused coding and payment suggestions designed to aid underserved communities. These encompass specific caregiver training initiatives, distinct coding and payment structures for community health integration services, compensation for principal illness navigation services coding, and remuneration for assessments of health risk stemming from social determinants.

The Proposed Rule also establishes compensation for specific dental services that are rendered before and during various cancer treatments, including chemotherapy. The agency also puts forth a number of novel behavioral health provisions to enhance care accessibility, enabling marriage and family therapists as well as mental health counselors to register for Medicare and invoice their services for the first time.

In the realm of its Medicare Shared Savings Program (MSSP), the CMS proposes fresh changes to advocate comprehensive individual care, encompassing revisions to both the Accountable Care Organization (ACO) assignment methodology and financial benchmarking methodology.

Furthermore, the rule recommends postponing the application of a fresh policy that would tie the payment rate for split (or shared) evaluation and management visits to the duration expended by the billing practitioner. The agency also presents the extension of several telehealth provisions, including reimbursement at non-facility rates for specific telehealth services delivered in a patient's residence.

The Proposed Rule is presently open for a 60-day comment period that concludes on September 11, 2023. It is anticipated that the Final Rule, along with incorporated comments, will be released in early November 2023.

Highlights of the CMS Proposal

● Expanding flexibilities to allow split/shared evaluation and management (E/M) visits to be charged based on one of three elements (history, examination, or medical decision-making) or time until at least 2024.
● Modifying the roster of telehealth practitioners to formally include marriage and family therapists as well as mental health counselors as telehealth practitioners, effective from January 1, 2024.
● Reimbursing telehealth services provided to patients in their residences at the typically higher, non-facility progression-free survival (PFS) rate.
● Maintaining the authorization for direct supervision by an overseeing practitioner through real-time audio and video telecommunications interaction until 2024. This also applies to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
● Continuing the coverage and payment of telehealth services enlisted on the Medicare Telehealth Services List until 2024.
● Initiating the execution and withdrawal of the Appropriate Use Criteria program regulations.
● Raising the performance threshold from 75 points to 82 points for all three reporting alternatives within the Merit-Based Incentive Payment System (MIPS).
● Introducing five new MIPS Value Pathways centered around women's health, prevention and management of infectious diseases, quality care for mental health/substance use disorders, quality care related to ear, nose, and throat concerns, and rehabilitative support for musculoskeletal care.

It's imperative to stay updated on the significant changes in the way of CMS services, and for this, there are various paths that you can take, such as attending sessions, meeting with industry experts, and more. Conference Panel initiates to acknowledge professionals with the proposed changes through various learning modes such as live webinars. To explore further, you can join the session with the industry-renowned subject expert.

https://conferencepanel.com/conference/cms-physician-proposed-rule-2024

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This release was published on openPR.