Medicare RBRVS Changes in 2023 (January 2023)

Why This Topic Matters

These annual Medicare payment updates can affect reimbursement, practice planning, documentation workflows, and code valuation across many specialties. Understanding the scope of the changes helps organizations assess financial impact and prepare for policy and coding updates tied to the 2023 fee schedule.

Article Sections

1. Conversion Factor for 2023

   Summarizes the annual Medicare physician payment update and the related factors affecting the 2023 fee schedule. It also discusses broader advocacy concerns surrounding Medicare payment stability.

2. Medicare Physician Payment Reform

   Addresses broader physician payment reform efforts and related advocacy themes. It places the fee schedule changes within ongoing policy discussions.

3. Coding Changes and Work Relative Values

   Reviews CMS and RUC activity related to valuation updates for selected service areas. It covers the types of services affected and the role of relative value recommendations.

4. Medicare Telehealth

   Summarizes telehealth coverage and payment policy changes under Medicare for the current period. It includes temporary extensions, category-based list changes, and related implementation timing.

5. E/M Visits

   Discusses evaluation and management visit policy updates across multiple settings. It covers revisions tied to Medicare valuation and related prolonged-service policies.

6. Split (or Shared) E/M Visits

   Describes Medicare policy timing and clarification issues for split or shared visits performed in facility settings. It also references related CPT workgroup activity.

7. Vaccine Administration Services

   Covers Medicare payment and valuation updates for vaccine administration services. It includes preventive vaccine administration, COVID-19 vaccine administration, and geography-based adjustments.

8. Chronic Pain Management

   Introduces new Medicare payment policies for chronic pain management services. It outlines the general structure of the monthly bundled approach and the affected service category.

9. Behavioral Health Services

   Summarizes changes affecting Medicare payment and supervision requirements for behavioral health services. It addresses participation by additional behavioral health practitioners and integration with primary care.

10. Expansion of Coverage for Colorectal Cancer Screening

    Discusses Medicare coverage expansion and beneficiary cost-sharing changes for colorectal cancer screening. It focuses on screening access and related coverage circumstances.

11. Audiology Services and Waiver of Physician Order

    Covers Medicare policy changes for certain audiology services and related ordering requirements. It also references a new modifier used for identifying services furnished under the updated policy.

12. Dental and Oral Health Services

    Reviews Medicare payment policies for dental services tied to covered medical care. It includes the types of circumstances addressed for dental coverage.

13. PLI Premiums Update

    Summarizes updates to professional liability insurance data used in Medicare valuation. It also discusses specialty-specific premium data and related adjustments.

14. Clinical Labor Pricing Update

    Describes updates to clinical labor pricing and the broader transition affecting practice expense inputs. It explains the timing and policy context for the pricing update.

15. Updates to PE Data Collection and Methodology

    Covers practice expense data collection efforts and changes to the methodology used in Medicare valuation. It also discusses related survey work and implementation timing.

16. Potentially Misvalued Services

    Reviews the work of CMS and RUC in identifying services for reevaluation. It addresses the broader process used to study valuation concerns over time.

17. Medicare’s Quality Payment Program

    Summarizes the Medicare quality payment framework and the relevant performance pathways. It includes the article’s discussion of program timing and resource references.