On July 13, 2023, CMS issued the CY 2024 Physician Fee Schedule (PFS) proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues.
CMS encourages you to review the rule and submit formal comments by September 11, 2023.
A few of the proposal highlights are as follows:
By factors specified in law, overall payment rates under the PFS are proposed to be reduced by 1.25% in CY 2024 compared to CY 2023. CMS is also proposing significant increases in payment for primary care and other kinds of direct patient care.
The proposed CY 2024 PFS conversion factor is $32.75, a decrease of $1.14 (or 3.34%) from the current CY 2023 conversion factor of $33.89.
For CY 2024, CMS is proposing to make payment when practitioners train and involve caregivers to support patients with certain diseases or illnesses (e.g., dementia) in carrying out a treatment plan.
For CY 2024, CMS is proposing coding and payment changes to better account for resources involved in furnishing patient-centered care involving a multidisciplinary team of clinical staff and other auxiliary personnel.
Beginning January 1, 2024, CMS is proposing to implement a separate add-on payment for healthcare common procedure coding system (HCPCS) code G2211. This add-on code will better recognize the resource costs associated with evaluation and management visits for primary care and longitudinal care of complex patients.
For split (or shared) E/M visits, CMS is proposing to maintain the current definition of substantive portion for CY 2024 that allows for the use of either one of the three key components (history, exam, or MDM) or more than half of the total time spent to determine who bills the visit.
For CY 2024, CMS is proposing to continue many of the flexibilities that practitioners have had during the PHE to furnish telehealth services until the end of 2024, as per statutory requirements.
CMS is proposing to allow teaching physicians to use audio/video real-time communications technology when the resident furnishes Medicare telehealth services in all residency training locations through the end of CY 2024.
CMS is proposing to allow MFTs and MHCs to enroll in Medicare after the CY 2024 Physician Fee Schedule final rule is published, and they would be able to bill Medicare for services starting January 1, 2024, consistent with the statute.
