Billing Beat

Proposed Medicare Physician Fee Schedule Includes Payment Cuts

August 5, 2022

The Centers for Medicare and Medicaid Services (CMS) released the 2023 Physician Fee Schedule (PFS) proposed rule, and medical associations are not happy with the proposed changes.

Namely, the 2023 plan would actually cut payments by 4.4%, as the proposed calendar year 2023 PFS conversion factor is $33.08, a decrease of $1.53 to the 2022 PFS conversion factor of $34.61. 

Physician services that are paid under the PFS are across a variety of settings, including physician offices, hospitals, ambulatory surgical centers (ASCs), skilled nursing facilities and other post-acute care settings, hospices, outpatient dialysis facilities, clinical laboratories and beneficiaries’ homes. Suppliers for technical services are also paid under the PFS when institutional payments are not made. Medicare typically makes payments under a single rate for services, while PFS rates paid to physicians and other billing practitioners in facility settings reflect only the portion of the resources typically incurred by the practitioner in the course of furnishing the service. Diagnostic tests and some other services may have a separate payment under PFS, and the system bases payments on the relative resources typically used to furnish the service

The proposed rule solicits public comments on the policy changes, and stakeholders can leave public comments prior to the finalization of the PFS.

Tags: CMS

Source: https://healthexec.com/topics/healthcare-management/healthcare-policy/proposed-medicare-physician-fee-schedule-includes

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