2023 Medicare Physician Fee Schedule

On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) issued the Medicare Physician Fee Schedule (PFS) final rule for calendar year (CY) 2023. The PFS final rule includes updates and policy changes for Medicare payment policies, payment rates, and other Medicare Part B issues. It is effective on or after January 1, 2023.

The CY 2023 relative value unit (RVU) conversion factor (CF) is $33.06, a decrease of $1.55, or approximately 4.5%, from the 2022 CF which was $34.61. This is due to an expiring 3% increase funded by Congress through 2022 and an approximate 1.5% decrease due to budget neutrality requirements.

The AOA is urging Congress to prevent this payment cut and implement an update for physicians due to inflation and increased practice costs. The AOA is also advocating to prevent a 4% pay-as-you-go (PAYGO) reduction and a scheduled 5% payment cut for Advanced Alternative Payment Models (APMs) as part of the Quality Payment Program (QPP).

CMS has extended payments for numerous Medicare telehealth services that have been temporarily available due to the COVID-19 Public Health Emergency (PHE). CMS is extending the duration of time that services are included on the Medicare telehealth services list for a period of 151 days following the end of the PHE, as per the Consolidated Appropriations Act, 2022 (CAA, 2022). These telehealth services will continue to be available in communities nationwide.

CMS has also adopted the CPT guidelines and codes and the AMA/Specialty Society RVS Update Committee (RUC) recommended RVUs for additional evaluation and management (E/M) visits. These include code families for hospital visits, home visits, nursing facility visits, and emergency department visits and allow for time or medical decision-making to be used to select the E/M visit level.

The AOA is advocating for Congress to avert the cuts in the PFS and is working diligently on a detailed summary of the final rule. If you have any additional questions, please do not hesitate to contact me directly.

Sincerely,

John-Michael

John-Michael Villarama, MA

Vice President, Public Policy

American Osteopathic Association

511 2nd St. NE

Washington, D.C. 20004