2024 Physician Fee Schedule Final Rule Released

2024 Physician Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) released the final rule for the 2024 Medicare Physician Fee Schedule (PFS) on November 2, 2023. The PFS is the payment system that determines how much Medicare pays for the services of physicians and other health care providers.

The final rule includes several changes that affect the reimbursement rates, quality measures, and reporting requirements for different types of services. One of the most significant changes in the final rule is the reduction of the PFS conversion factor, which is the amount that Medicare pays per service unit.

The 2024 conversion factor is $32.7442, which is 3.37% lower than the 2023 conversion factor of $33.8872. This means that Medicare will pay less for most services in 2024 unless other adjustments increase the payment rates.

Another important change in the final rule is the expansion of telehealth services, which are healthcare services delivered remotely using technology.

CMS added several new codes to the list of telehealth services that are covered by Medicare, such as remote patient monitoring, behavioral health counseling, and emergency department visits.

CMS also extended some of the telehealth flexibilities that were introduced during the COVID-19 public health emergency, such as allowing audio-only visits for certain services.

The final rule also includes updates to the Quality Payment Program (QPP), which is the system that rewards or penalizes providers based on their performance on quality and cost measures.

CMS made some changes to the two tracks of the QPP: the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs). For example, CMS increased the performance threshold for MIPS, which is the minimum score that providers need to avoid a negative payment adjustment.

CMS also added new measures and activities to the MIPS categories of quality, cost, improvement activities, and promoting interoperability. For APMs, CMS modified the criteria and benchmarks for qualifying as an advanced APM and earning a bonus payment.

The final rule also addresses other topics, such as the valuation of specific services, the supervision requirements for non-physician practitioners, the payment for chronic care management, and opioid treatment programs.

The final rule is effective on January 1, 2024, and applies to services furnished in calendar year 2024.

The final rule also includes some of the most important changes to improve access to behavioral health care in Medicare’s history, such as expanding the telehealth services and the billing providers for mental health and substance abuse services. Behavioral Health Billing is the process of coding and submitting claims for these services, which often have different requirements and limitations than medical billing

How Medical Billers and Coders Can Help You

 

Medical Billers and Coders are the professionals who handle the administrative aspects of health care, such as coding the services, submitting the claims, and collecting the payments. We play a vital role in ensuring that healthcare providers receive accurate and timely reimbursement for their services.

Medical Billers and Coders can help you by:

 

  • Coding the services according to the latest standards and guidelines, such as the International Classification of Diseases (ICD), the Healthcare Common Procedure Coding System (HCPCS), and the Current Procedural Terminology (CPT).
  • Submitting the claims to the appropriate payers, such as Medicare, Medicaid, or private insurance companies, using the correct forms and formats.
  • Following up on the claims and resolving any issues, such as denials, rejections, or underpayments, by contacting the payers or the providers.

Get in touch with Medical Billers and Coders

Medical Billers and Coders can help you save time, money, and hassle by taking care of the complex and tedious tasks of medical billing and coding. We can also help you improve your cash flow, reduce your errors, and comply with the regulations.

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We are here to help you achieve your financial goals and grow your practice. Don’t wait, Contact us now at info@medicalbillersandcoders.com or call them at 888-357-3226 and let us handle your medical billing and coding needs.

FAQs

  1. What is the 2024 Physician Fee Schedule Final Rule?
    • It is a rule that announces the policy changes for Medicare payments under the PFS and other Medicare Part B issues, effective on or after January 1, 2024.
  1. How does the 2024 PFS Final Rule affect the payment rates for physicians and other providers?
    • The rule reduces the overall payment rates by 1.25% and lowers the conversion factor by 3.4%, but also increases the payment for primary care and other direct patient care services.
  1. What are the major changes in the 2024 PFS Final Rule for the Quality Payment Program?
    • The rule includes changes to the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs), such as the performance threshold, the measures and activities, the reporting requirements, and the payment adjustments.
  1. How does the 2024 PFS Final Rule expand the telehealth services covered by Medicare?
    • The rule adds several new codes to the list of telehealth services, such as remote patient monitoring, behavioral health counseling, and emergency department visits, and extends some of the telehealth flexibilities that were introduced during the COVID-19 public health emergency.