On July 10, 2024, 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 2025, including several proposals which show the impact of AAPM&R advocacy efforts throughout the year. AAPM&R submitted comprehensive comments to CMS regarding the proposed rule on September 9.
Effective January 1, 2024 the Centers for Medicare and Medicaid Services implemented payment for G2211, a HCPCS add-on code to be billed in conjunction with an office/outpatient evaluation and management (E/M) code in certain instances. Learn more about how to use this resource and applications for physiatry.
On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) released the calendar year 2024 Medicare Physician Fee Schedule. Policies described in the rule will go into effect on January 1, 2024. AAPM&R submitted detailed comments to CMS regarding their proposed rule in September.
The rule finalized a 3.37% reduction to the Conversion Factor, decreasing from the 2023 rate of $33.89 to $32.74. On March 8, following extensive AAPM&R advocacy, Congress passed a partial government funding package which included an update to the conversion factor. The conversion factor for the remainder of 2024, effective March 9, is $33.29. Download our updated AAPM&R payment comparison chart to see 2024 payment rates for physiatry services effective March 9.
AAPM&R has successfully advocated on several policies finalized in the 2024 rule:
We are reviewing the rule in further detail and will be preparing additional summary information for members including specific information about payment rates for physiatry services. The rule includes new policies related to telehealth, new coding opportunities for E/M visits with complex patients and for caregiver training services, as well as updates to several important quality programs.
See the Academy's advocacy efforts for this final rule:
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.
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.