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.
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 healthpolicy@aapmr.org.
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.