decisionhealth Newsletters, Coder Pink Sheets - 2023 Issue 7 (July)
Rules & regulations: Proposed 2024 PFS shows 3.4% pay cut, delay of split/shared rule and more
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Article Overview
This article summarizes major elements of CMS’s proposed 2024 Medicare physician fee schedule. It is relevant to physicians, coders, compliance staff, and practice administrators who need to track payment updates, telehealth policy, quality program changes, shared savings proposals, and the introduction or status changes of several new and revised service codes.
Why This Topic Matters
The proposal affects Medicare payment rates, coding availability, telehealth reimbursement, quality reporting, and practice operations across multiple specialties. Readers can use it to understand the scope of upcoming policy changes and decide which sections of the proposed rule may affect their workflows.
Article Sections
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Payment updates and conversion factors
Summarizes the proposed Medicare Part B and anesthesia payment updates for the coming year and frames the overall fee schedule impact.
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Add-on visit-complexity code is back
Discusses the return of a billing code tied to office visit complexity and describes its proposed status change and reporting context.
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Get an early look at new codes
Introduces newly proposed code additions across several service areas, including imaging, congenital heart procedures, spine-related services, nerve stimulation, and other procedural categories.
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Discover more critical proposals
Covers additional proposed policy changes affecting split/shared visits, telehealth, social determinants of health, remote therapeutic monitoring, therapy, diabetes screening, and related coverage updates.
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Shared Savings updates
Outlines proposed changes for Medicare Shared Savings Program ACO quality reporting, beneficiary assignment, risk adjustment, equity scoring, and program track structure.
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QPP and MIPS changes
Reviews proposed updates to quality payment scoring, new pathway measures, cost measures, performance thresholds, and advanced APM participation requirements.
What You Will Learn
- How the proposed 2024 physician fee schedule affects Medicare payment rates and practice operations
- Which broad service areas are seeing new or revised code proposals
- What policy changes are proposed for telehealth, split/shared visits, RTM, therapy, and diabetes screening
- How Shared Savings ACO and QPP/MIPS reporting proposals may change quality and performance requirements
- Which CMS proposals may matter for specialty practices, billing teams, and compliance staff
Who Should Read This
- Physicians and clinician practices
- Medical coders and billing staff
- Practice administrators
- Compliance professionals
- Quality reporting teams
- ACO and value-based care leaders
Codes Discussed
Modifiers Discussed
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