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REGULATORY ALERT: Medicare proposes 2024 payment and quality reporting changes

07/14/2023 11:11 AM | Rebekah Francis (Administrator)

Medicare proposes 2024 payment and quality reporting changes

The Centers for Medicare & Medicaid Services (CMS) released the 2024 Medicare Physician Fee Schedule (PFS) proposed rule this afternoon, which includes proposed changes to the Merit-based Incentive Payment System (MIPS) and alternative payment model (APM) participation options and requirements for 2024. Key proposals include:

  • Setting 2024 Medicare payment rates for physician services. For 2024, CMS proposes a Conversion Factor of $32.7476 and $20.4370 for Anesthesia (a decrease of -3.4% and -3.3%, respectively, over final 2023 rates);
  • Extending flexibilities to permit split/shared E/M visits to be billed based on one of three components (history, exam, or medical decision making) or time through at least 2024, following MGMA advocacy;
  • Reimbursing telehealth services furnished to patients in their homes at the typically higher, non-facility PFS rate;
  • Continuing to allow direct supervision by a supervising practitioner through real-time audio and video interaction telecommunications through 2024;
  • Continuing coverage and payment of telehealth services included on the Medicare Telehealth Services List through 2024;
  • Pausing implementation and rescinding the Appropriate Use Criteria program regulations;
  • Increasing the performance threshold from 75 points to 82 points for all three MIPS reporting options;
  • Adding five new MIPS Value Pathways related to women's health, prevention and treatment of infectious disease, quality care in mental health/substance use disorder, quality care for ear, nose, and throat, and rehabilitative support for musculoskeletal care;
  • Making numerous changes to the Medicare Shared Savings Program (MSSP) such as revising the MSSP quality performance standard, modifying the program’s benchmarking methodology, and determining beneficiary assignment under the MSSP; and,
  • Ending the 3.5% APM Incentive Payment after the 2023 performance year/2025 payment year, and transitioning to a Qualifying APM Conversion Factor in the 2024 performance year/2026 payment year.

MGMA will submit detailed comments in response to these proposals to CMS and prepare a more detailed analysis of proposed changes in the coming weeks. Review the proposed rule, the PFS fact sheet, and the QPP fact sheet. The final 2024 PFS rule is expected by Nov. 1, 2023.

Next Tuesday: Join MGMA for our mid-year policy update webinar

Join MGMA Government Affairs for our member-exclusive, mid-year policy update to review current federal policies and their impact on group practices. Attendees will learn about the congressional and regulatory landscape as it pertains to medical practices, federal payment issues on the horizon, and the latest on MGMA's advocacy and member engagement. There will be time for Q&A at the end of the presentation, so come ready with your questions!

This webinar will be held next Tuesday, July 18, 2023, at 1 p.m. ET and will eligible for ACMPE, ACHE (live only), CME (live only), CPE (live only), PDC (live only), PDU (live only) and CEU credit. Register for the webinar here


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