July 14, 2023 — The Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2024 Medicare Physician Fee Schedule (PFS) proposed rule to announce rate updates, advance health equity, and expand access to critical medical services — including behavioral health care and certa...
The Proposed Rule is open for a 60-day comment period that will close on Sept. 11, 2023. The Final Rule with comment is expected to be issued in early November 2023. To learn more about the Medicare Physician Fee Schedule Proposed Rule, review the following resources Proposed R...
Under the physician fee schedule (PFS), average payment rates will reduce the conversion factor by 2.83% in 2025 compared to 2024 rates, resting at $32.35 in 2025 compared to $33.29 in 2024. The PFS final rule eliminates the temporary 2.93% increase in Medicare physician paymen...
CMS’ proposed 2023 physician fee schedule includes a 4.42% reduction of the conversion factor, the starting point for calculating Medicare payments for physician services. The proposed conversion factor for calendar year 2023 is $33.08, a decrease of $1.53 from the 2022 PFS conversion factor of ...
In the CY 2023 Medicare Physician Fee Schedule (MPFS) final rule, CMS codified the JW modifier for wasted or discarded units. Some stakeholders commented that requiring the use of the JZ modifier would cause confusion and increase overhead burden among providers and was unnecessary ...
In its 2023 final physician fee schedule rule released November 2022, CMS finalized a series of significant changes to Medicare’s largest ACO program, the Shared Savings Program (MSSP).Some of the more minor changes included in that rule went into effect in 2023, while the most significant ch...
The Centers for Medicare & Medicaid Services (“CMS”) has announced its proposed rules for the Hospital Outpatient Prospective Payment (“OPPS”) and Ambulatory Surgical Center (“ASC”) Payment Systems, as well as its calendar year (CY) 2024 proposed Physician Fee Schedule (“PFS”), (...
“The legislation includes improvements to Medicare, especially cracking down on ghost networks in Medicare Advantage that prevented seniors from finding a physician or psychiatrist in their health plan,” he said. “There’s a lot more work to be done to improve mental health care for all Amer...
CMS proposes update to Medicare Physician Fee Schedule; patients with rare diseases struggle to gain expanded access to experimental treatments; a coalition of health care organizations calls on facilities to require the COVID-19 vaccine for workers....
The proposed 2022 Medicare Physician Fee Schedule and Quality Payment Program rules released by Centers for Medicare and Medicaid Services (CMS) may usher in a wide range of changes, including a 3.75% reduction in the conversion factor used to calculate payments to physicians. However, according to...