decisionhealth Newsletters, Part B News - 2022 Issue 7 (July)
Proposed PFS chops fees 4%, approves E/M remake, previews code changes
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Article Overview
This article explains the major elements of the proposed 2023 Medicare physician fee schedule, including payment updates, evaluation and management policy alignment, telehealth-related billing changes, shared savings program updates, and quality reporting revisions. It is relevant to physicians, billing and coding staff, compliance teams, and other stakeholders who track Medicare payment policy and annual code changes. The article also previews newly addressed services and identifies code families under review for valuation or coverage changes.
Why This Topic Matters
The proposed rule can affect Medicare reimbursement, documentation expectations, reporting workflows, and which services are covered or reviewed for valuation in the coming year. Readers who code for Medicare Part B services or manage practice operations need to understand the direction of these changes before they become final.
Article Sections
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Physician fee schedule
Introduces the proposed Medicare physician fee schedule and its overall direction for 2023. Summarizes the broad payment and policy context for Part B services.
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Aligning with recent E/M changes
Covers proposed alignment between Medicare billing requirements and recent evaluation and management updates. Discusses office, inpatient, observation, and prolonged service policy areas.
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More highlights from the rule
Presents additional proposed changes and previewed code activity across several service categories. Includes valuation review topics, telehealth, split/shared services, and surgical package issues.
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Medicare Shared Savings Program
Summarizes proposed changes affecting accountable care organizations and shared savings participation. Highlights financing, equity, and program design adjustments.
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QPP, MIPS updates
Reviews proposed updates to quality reporting and incentive programs under the QPP. Covers pathway changes, scoring structure, thresholds, and reporting-related requests for information.
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Vaccine administration
Addresses proposed coverage and payment adjustments related to vaccine administration. Includes ongoing COVID-related considerations and geographic and economic factors.
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Innovations in dental, audio, behavioral and more
Describes proposed expansion into additional service areas and new payment concepts. Touches on dental, audiology, behavioral health, and chronic pain-related services.
What You Will Learn
- What categories of Medicare payment and coverage changes are included in the proposed rule
- Which broad evaluation and management policy areas are being updated
- How the proposal affects telehealth, shared services, and quality reporting
- Which service categories are being previewed for new or revised Medicare consideration
- What program-level changes are proposed for shared savings and MIPS/QPP participants
Who Should Read This
- Physician practices
- Medical coders
- Billing departments
- Compliance teams
- Practice administrators
- Medicare policy analysts
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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