The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule that outlines its plans for Medicare physician payment policies in calendar year (CY) 2024. The proposed rule includes a number of changes, some of which are significant.
One of the most notable changes is a decrease in the conversion factor. The conversion factor is a dollar amount that is used to calculate Medicare payments for physician services. In CY 2024, CMS is proposing to reduce the conversion factor by 3.34%. This means that Medicare payments for physician services will decrease by an average of 3.34% in CY 2024.
CMS is also proposing to make a number of changes to specific payment codes. For example, CMS is proposing to increase payments for primary care services and for services that promote health equity. CMS is also proposing to decrease payments for certain high-cost services.
In addition to changes to payment rates, CMS is also proposing a number of new policies. For example, CMS is proposing to pay physicians and non-physician practitioners (NPPs) for training and involving caregivers in the treatment plan of patients with certain diseases or illnesses. CMS is also proposing to add social determinants of health (SDOH) risk assessment to the annual wellness visit (AWV) as an optional element with an additional payment.
The proposed rule is still in the early stages and CMS is seeking public comment on the proposed changes. The comment period closes on September 11, 2023. CMS will then review the public comments and make any necessary changes to the proposed rule before it is finalized.
The proposed rule is a significant development in the ongoing debate over Medicare physician payment policies. The changes proposed by CMS will have a major impact on Medicare beneficiaries, physicians, and other healthcare providers. It will be important to monitor the rulemaking process and to provide feedback to CMS on the proposed changes.
Here are some of the key takeaways from the proposed rule:
The conversion factor will be reduced by 3.34% in CY 2024.
Payments for primary care services and services that promote health equity will be increased.
Payments for certain high-cost services will be decreased.
CMS is proposing a number of new policies, such as paying physicians and NPPs for training and involving caregivers in the treatment plan of patients with certain diseases or illnesses, and adding SDOH risk assessment to the AWV as an optional element with an additional payment.
The comment period closes on September 11, 2023.
The proposed rule is a complex document and it is important to carefully review it to understand the full impact of the proposed changes. If you have any questions or concerns about the proposed rule, you should contact CMS or your healthcare provider.