On November 26 Health Reform Simplified webinar, the NextGen Healthcare regulatory affairs team presented an overview of the final rule for the 2024 Medicare Physician Fee Schedule (PFS), released by the Centers for Medicare and Medicaid Services (CMS) on November 2.
The 2,709-page final regulation updates payment policies and programs regarding Medicare payments to physicians and other providers under the PFS. As in previous years, this year’s rule includes critically important policy updates concerning such issues as Medicare payment rates, telehealth services, accountable care organizations (ACOs), and the Merit Based Incentive Payment System (MIPS). The rule sets out to:
- Reduce FFS Medicare payment rates across-the-board by 3.4 percent in 2024.
- Authorize a $16 payment for a new add-on code for primary care-focused Medicare office visits. Medicare will begin paying the code $16 per visit for the new add-on code (G2211) for “inherently complex evaluation and management visits” starting January 1, 2021.
- Extend key Medicare telehealth policies that were in effect during HHS’s COVID-19 emergency through December 2024.
- Permanently establish payment parity between Medicare telehealth visits and in-person office visits.
- Maintain the Merit Based Incentive Payment System (MIPS) scoring threshold at 75 points. The performance threshold is the total score at which neutral MIPS payment adjustments apply; scores above or below the threshold result in positive or negative adjustments, respectively.
- Implement minor updates to the MIPS Quality, Cost, and Improvement Activities performance categories and measures. As prescribed by law, in 2024 the MIPS performance category weights will remain the same as in 2023: 30% for quality; 30% for cost; 15% for improvement activities; and 25% for promoting interoperability.
- Change the MIPS Promoting Interoperability performance category reporting period from 90 to 180 days. Since the launch of the MIPS program in 2017, as well as under the previous CMS meaningful use programs, the performance period for meaningful use of certified EHR has been 90 days.
- Remove the MIPS Promoting Interoperability performance category exemption for several types of clinicians including clinical psychologists and physical therapists.
- Continue the rollout of the MIPS Value Pathways (MVPs) voluntary MIPS participation option with the addition of five new MVPs.
- Continue the rollout of the voluntary MIPS Value Pathways (MVPs) option with the addition of five new MVPs.
- Implement changes to the Shared Savings ACO program to further implement the significant program reforms finalized last year.
For more details regarding these and other provisions of the final rule, review the CMS press announcement.