Proposed PFS chops fees 4%, approves E/M remake, previews code changes

Why This Topic Matters

The proposed rule signals changes that can affect Medicare reimbursement, documentation workflows, telehealth reporting, care coordination programs, and operational planning for 2023 and beyond. Readers can use it to identify which areas of the fee schedule may require follow-up once final rules are issued.

Article Sections

1. Proposed 2023 Medicare physician fee schedule overview

   Introduces the proposed rule and the broad categories of projected changes affecting Medicare Part B payment and related policy areas.

2. Aligning with recent E/M changes

   Discusses CMS alignment with recent evaluation and management guideline updates and the affected service families.

3. More highlights from the rule

   Summarizes additional proposed changes involving newly previewed codes, work RVU adjustments, telehealth reporting, split/shared services, and surgical package valuation.

4. Medicare Shared Savings Program

   Covers proposed Medicare Shared Savings Program updates, including support for certain ACOs and program simplification efforts.

5. QPP, MIPS updates

   Outlines proposed changes to the Quality Payment Program and the migration toward the MIPS Value Pathways model.

6. Vaccine administration

   Notes proposed coverage and payment-related adjustments tied to vaccine administration and pandemic-era considerations.

7. Innovations in dental, audio, behavioral and more

   Describes proposed additions and expansions in selected service areas, including dental, audiology, chronic pain, and behavioral health.