CMS released the final 2023 Medicare Physician Payment Schedule on Nov. 1. The more than 3,300-page document will take some time to review and summarize, but our first quick and focused look provides the following:
- The 2023 Medicare conversion factor is $33.06 – a decrease of 4.5% from the 2022 conversion factor of $34.61. The large decrease is mainly attributed to the expiring 3% Congressional funding from 2022. Additionally, 1.6% of the decrease is due to the statutory budget neutrality requirements, which stem from the revised E/M visit code families (hospital visits, emergency department visits, home visits and nursing facility visits).
- Medicare covered telehealth services will be paid at the same rate as in-person visits through at least the end of 2023.
- Medicare telehealth services covered during the PHE will be extended for 151 days past the end of the PHE.
- Beginning Jan. 1, 2023, any Remote Therapeutic Monitoring (RTM) service (CPT codes 98975, 98976, 98977, 98980, and 98981) may be furnished under general supervision. This includes clinical labor services such as communicating with the patient, resolving technology concerns, reviewing data, updating and modifying care plans, and addressing issues if the patient’s condition is not improving that can be furnished by auxiliary personnel. (Currently, a physician, nurse practitioner or physician assistant is required to directly supervise clinical staff furnishing these services.) This opens up options for allergists providing RTM services, including having third party vendors provide RTM services.
- Allergy/Immunology MIPS Specialty Measure Set – Two quality measures were added: Screening for Social Drivers of Health and Adult Immunization Status. Two quality measures were removed: Preventive Care and Screening: Influenza Immunization and Pneumococcal Vaccination Status for Older Adults.
- CMS set the MIPS exceptional performance threshold at 89 points.
- MIPS Quality Measures – Nine quality measures were added, 11 were removed, and 76 existing measures had substantive changes.
The Advocacy Council will continue its review of the final rule and provide a more detailed summary. Please watch for updates in upcoming the Advocacy Insider articles. In the meantime, you may find the following resources helpful.
The Advocacy Council – ADVOCATING FOR ALLERGISTS AND THEIR PATIENTS.
