On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) published the annual Medicare Physician Fee Schedule (MPFS) proposed rule. The rule describes proposed payment, policy, and quality program changes for 2023, including several proposals which may impact physiatry. On September 11, 2023, AAPM&R submitted comments to CMS regarding the proposed rule on behalf of physiatry. Additionally, 142 Academy members submitted letters to CMS as a part of the Academy’s grassroots letter writing campaign.
On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) published the annual Medicare Physician Fee Schedule final rule, finalizing payment and policy changes effective January 1, 2023. In an end of year Omnibus bill, Congress provided partial relief to the scheduled cuts to 2023 physician payment rates. Download our updated AAPM&R payment comparison chart to see final 2023 payment rates for physiatry services reflective of the new conversion factor and other finalized changes.
Updates to Physician Payment
End of year legislation cushioned the 4.5 percent Conversion Factor reduction previously finalized in the November 2022 rule. The final Conversion Factor for 2023 is $33.89, a 2.0 percent reduction from the 2022 Conversion Factor of $34.61. AAPM&R advocated throughout 2022, asking Congress to prevent the entire 4.5 percent reduction. A huge thank you to the 230 Academy members who wrote over 680 letters to Congress urging action on this issue. AAPM&R was extremely disappointed that Congress provided only partial relief from the scheduled cuts to payment. Annual cuts continue to the norm, prompting AAPM&R and many other medical specialties to push for comprehensive payment reform, including positive annual updates.
Additional Policy Changes for 2023
CMS finalized several major changes to coding, coverage and payment for 2023:
A comprehensive fact sheet about the rule is available on the CMS website. If you have specific questions about the final rule, please email email@example.com.
Updated December 2021
Following the November 2, 2021 publication of the annual Medicare Physician Fee Schedule final rule by the Centers for Medicare & Medicaid Services (CMS), several updates have been made impacting the Conversion Factor. On December 10, legislation was signed averting an almost 10% cut to the fee schedule, which was scheduled to take effect January 1. AAPM&R advocated against these cuts throughout 2021, culminating in a grassroots advocacy campaign this November, during which 208 members sent a total of 635 messages to their Congressional Leaders. As a result, rather than a 10% cut, the fee schedule will see a 0.83% cut to payment. As of late December, CMS has finalized a 2022 Conversion Factor of $34.6062, decreased from the 2021 Conversion Factor of $34.8931.
Click here for a chart of final RVUs and payment rates for physiatry services effective January 1, 2022 reflective of the updated $34.6062 Conversion Factor.
While the December 10 legislation is a huge win for physiatry and the entire house of medicine, the changes to physician payment in the bill are only a temporary solution, as they expire at the end of 2022. We anticipate we will be advocating early and throughout 2022 to urge Congress to identify a permanent solution to the payment cuts physicians have been facing each year in recent history.
The rule finalizes payment and policy changes which will take effect January 1, 2022. Earlier this year, your Academy submitted detailed comments to CMS regarding the proposed rule. The rule also finalizes policy on several issues your Academy has been monitoring including:
A comprehensive fact sheet is now available on the CMS website.
The complete rule is available on the Federal Register website.
A detailed CMS fact sheet is available on the Medicare website.
Medicare payment for physicians, and some non-physician practitioners (NPPs), is based on set rates under Medicare Part B. The system for payment, known as the Medicare Physician Fee Schedule (MPFS), is used when paying for: professional services of physicians and some NPPs; covered services incident to physicians’ services (other than certain drugs covered as incident to services); diagnostic tests (other than clinical laboratory tests); and radiology services. The MPFS also addresses various quality issues, fraud and abuse issues, and other issues that impact physicians. CMS updates the MPFS regulations annually, with comment periods open prior to implementation of the final rule.