2024 Medicare Physician Fee Schedule Proposed Rule

 On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule seeking public feedback on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues.

These changes are set to take effect on or after January 1, 2024. The proposed rule for CY 2024 PFS is part of a larger effort by the current administration to create a more equitable healthcare system that improves access to care, quality, affordability, and innovation.

Background on the Physician Fee Schedule

Medicare has used the Physician Fee Schedule (PFS) to pay for physicians’ and other billing professionals’ services since 1992. These services are provided in a variety of settings, including hospitals, physician offices, skilled nursing facilities, hospices, and outpatient dialysis facilities. Medicare makes payments to physicians and other professionals at a single rate for most services furnished in a physician’s office. However, PFS rates paid to physicians in facility settings, such as hospital outpatient departments (HOPDs) or ambulatory surgical centers (ASCs), only reflect the portion of resources typically incurred by the practitioner in providing the service.

For many diagnostic tests and a limited number of other services under the PFS, separate payment may be made for the professional and technical components of services. The technical component is often billed by suppliers such as independent diagnostic testing facilities and radiation treatment centers, while the professional component is billed by the physician or practitioner.

Payments are based on the relative resources typically used to furnish the service. Relative value units (RVUs) are applied to each service for work, practice expense, and malpractice expense. These RVUs become payment rates through the application of a conversion factor. Geographic adjusters are also applied to the total RVUs to account for variation in costs by geographic area. Payment rates are calculated to include an overall payment update specified by statute.

https://www.allzonems.com/2024-medicare-physician-fee-schedule-proposed-rule/

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