2024 CMS Physician Fee Schedule Updates

The Centers for Medicare and Medicaid Services (CMS) has released the 2024 Medicare Physician Fee Schedule (PFS), and physicians should now expect another payment cut. The Medicare finalized conversion factor has been cut 3.4% from the 2023 rate to $32.7442. The 2023 rate was already cut 2% from 2022. The Medicare Economic Index, which measures practice cost inflation, has increased to 4.6%, which is up even more from the 3.8% increase last year.

The PFS only applies to Medicare reimbursements; however, many private payer contracts are tied to the Medicare rates. Physicians will be limited in what they can collect from private payers due to these cuts.

Other Changes to the Fee Schedule

• The coverage and payment of telehealth services that are found on the Medicare Telehealth Services list will remain through 2024.
• Reimbursed telehealth services will be paid to patients in their homes at the non-facility, and typically higher, PFS rate.
• It allows for direct supervision by a supervising practitioner through real-time audio and video telecommunications through 2024.
• These changes implement an E/M add-on code G2211. The substantive portion of a split (or shared) E/M visit is defined as more than half of the total time spent by the physician or nonphysician practitioner or a substantive part of the medical decision making.

Changes to Quality Programs and Their Criteria

• The reporting options for all three Merit-Based Incentive Payment Systems (MIPS) will stay at a threshold of 75 points.
• Five new MIPS Value Pathways have been added related to rehabilitative support for musculoskeletal care, women’s health, quality care in mental health/substance use disorder, prevention and treatment of infectious disease, and quality care for ear, nose, and throat.
• The Medicare Share Savings Program (MSSP) has undergone several changes, including modifying the program’s benchmarking methodology, determining beneficiary assignment, and revising the MSSP quality performance standard.
• The 3.5% APM Incentive Payment now ends after the 2023 performance year/2025 payment year and becomes the Qualifying APM Conversion Factor for the 2024 performance year/2026 payment year.

In a statement released by CMS, CMS Administrator Chiquita Brooks-LaSure explains the reasoning behind these changes. “CMS remains steadfast in our commitment to supporting physicians and ensuring that people with Medicare have access to the care they need to stay healthy as well as navigate health conditions they are facing. CMS is taking important steps toward those goals in this rule by improving payment for primary care and access to mental health care, paying for new navigation services to help people with cancer and other serious illnesses navigate their treatment, supporting family caregivers, paying for services involving community health workers to address health-related social needs that impact care, and enhancing access to dental care for people with certain cancers.”

While these changes in the Medicare Physician Fee Schedule may be concerning, the Baldwin CPAs team is here to help you make sense of these changes and ensure that your business remains up to date. Our experienced healthcare team works diligently to stay abreast of all new government regulations, so you can focus on providing your patients with quality care. Contact us today for more information on how Baldwin can serve your practice.