CMS Proposed Fee Schedule for CY 2024: Key Changes and Implications

On July 13, the Centers for Medicare & Medicaid Services (CMS) unveiled its proposed rule for the physician fee schedule in calendar year 2024. This proposal presents significant adjustments, including a 3.34% decrease in the conversion factor, setting it at $32.75 for CY 2024, down from $33.89 in CY 2023. This shift results from multiple factors, such as the expiration of the 2.5% statutory payment increase for CY 2023, a 1.25% statutory payment increase for 2024, a 0.00% conversion factor update due to the Medicare Access and CHIP Reauthorization Act, and a -2.17% budget-neutrality adjustment.

Furthermore, CMS suggests delaying the implementation of a policy that defines split (or shared) visits based on the billing practitioner's time spent, potentially impacting Medicare reimbursement rates. Behavioral health services are also in focus, with proposals for new benefit categories for marriage and family therapists and mental health counselors under Part B, along with the introduction of payment codes for mobile psychotherapy for crisis services.

Within the Quality Payment Program (QPP), CMS introduces five new, optional Merit-based Incentive Payment System Value Pathways for reporting starting in 2024. They also intend to raise the performance threshold score for MIPS participants and the quality data completeness threshold. For the Advanced Alternative Payment Model (APM) track, CMS proposes Advanced APM Incentive Payments in CY 2025 for eligible clinicians, mandated by the Consolidated Appropriations Act of 2023.

Moreover, CMS seeks to extend various telehealth waivers, make revisions to data reporting and payment reductions for clinical laboratory tests, and maintain and expand additional payments for certain in-home vaccine administrations. Medicare Shared Savings Plan quality measurement policies are also on the agenda.

Join our expert, Lynn A. Anderanin, CPC, CPPM, CPMA, CPC-I, COSC, in this information-packed webinar as she unpacks the proposed rule changes. Lynn will provide valuable insights to help attendees understand the implications of these proposed rules on medical providers and the services and procedures they perform.

Webinar Agenda

• Discuss the new proposed rules to determine which one(s) will affect the provider
• Send comments to CMS if there is a strong negative opinion about a rule
• Watch for the final rule in the federal register in November
• Create an implement the pertinent final rule(s) in January or otherwise noted.

Webinar Highlights

• Determine what the proposed rules mean and how they will affect the providers
• Allow office staff to share their opinions on the rules
• Submit comments through the described process
• Decipher between the proposed rule(s) and the final rule(s)
• Implement the final rule(s) by the effective date
• Review processes for efficiency after a specified period of time

Who Should Attend

Physicians, PAs, NPs, coders, billers, auditors, claims processors, claims adjuster, supervisor, manager, administrator.