2022 proposed physician fee schedule: CMS cuts conversion factor, offers PAs billing privileges, takes aim at split/shared services

Why This Topic Matters

The proposal can affect Medicare reimbursement, billing workflows, telehealth availability, and reporting requirements across multiple specialties and practice settings. It also signals where CMS may change documentation and compliance expectations for the following year.

Article Sections

1. Medicare fee schedule and conversion factor updates

   Overview of proposed payment updates under the Medicare physician fee schedule, including broad changes that may affect specialty reimbursement in the coming year.

2. Examples of payment impact by service type

   Illustrative discussion of how proposed payment changes may affect selected surgical and evaluation and management services.

3. Physician assistant billing and payment changes

   Discussion of proposed direct payment and reassignment policies for physician assistants under Medicare Part B.

4. Therapy assistant payment policy and modifiers

   Coverage of proposed changes affecting therapy assistant payment reductions and modifier reporting in outpatient therapy settings.

5. New CPT codes

   High-level summary of newly proposed CPT services that CMS identifies for the upcoming CPT cycle, including additions across multiple clinical areas.

6. Split/shared visits and critical care guidance

   Review of proposed policy changes for split/shared services in the facility setting and critical care guidance under Medicare.

7. Electronic prescribing enforcement

   Summary of proposed timing and compliance changes related to electronic prescribing of controlled substances for Medicare Part D.

8. Telehealth updates

   Overview of proposed telehealth policy revisions, including mental health coverage changes and adjustments to the telehealth services list.

9. Quality Payment Program and MIPS Value Pathways

   Discussion of proposed updates to MIPS scoring, performance thresholds, and the planned transition to Value Pathways.

10. Shared Savings Program updates

    Summary of proposed changes affecting accountable care organizations, quality scoring, and shared-risk participation requirements.

11. National coverage determinations proposed for deletion

    Review of selected national coverage determinations that CMS proposes to retire and related requests for public comment.