Highlights of the 2024 MPFS Final Rule: Enhancements in Coding and Billing



In case you’re pressed for time and can’t delve into the intricate details of the final medical fee schedule rule, it’s essential to at least grasp the following section.

Medicare directives wield substantial influence over policies across all payers. Hence, it’s imperative for individuals, healthcare providers, and entities such as medical billing companies dealing with health insurance claims to stay informed about policy alterations in the upcoming year. This can be achieved by reviewing the annual Medicare Physician Fee Schedule (MPFS) final rule

Key Points from the 2024 MPFS Final Rule: Updates on Evaluation and Management (E/M) Visits, Introduction of Complex Surcharge, and Extension of Vaccination Payments

Regrettably, navigating through the extensive document doesn’t offer the thrill of a fast-paced novel. To streamline your understanding and save time, here are the key highlights from the 2024 MPFS Final Rule pertinent to medical billing and coding:

Evaluation and Management (E/M) Visits: Introducing HCPCS Level II + G2211 Complex E/M Visit Surcharge effective January 1, 2024. This additional code can be reported alongside E/M Visits M in Office/Outpatient Visits to accommodate ‘additional resources’ required for primary care or similar ongoing medical care concerning the patient’s unique, serious, or complex circumstances, as explained by the Centers for Medicare and Medicaid Services (CMS) in the final report.

Vaccinations: During the COVID-19 public health emergency, Medicare provided providers with an additional $35.50 for administering COVID-19 vaccines to Medicare beneficiaries at their residences. CMS has prolonged this supplementary payment for at-home COVID-19 vaccinations as well as for pneumococcal, influenza, and hepatitis B vaccines through 2024, adjusted in accordance with the calendar year 2024 MEI percentage increase ($38.55). The co-payment is per visit, not per vaccination.

For more information: https://www.allzonems.com/2024-mpfs-final-rule-highlights/

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