September 15, 2022
Even though we're still in mid-summer, it's a good idea to plan for the coming year and prepare for possible changes in the way your medical practice receives the payment for services provided.
If your current patient base is comprised of Medicare patients or just the majority, it's essential to be aware of rules and updates concerning health insurance coverage. Consider that your local demographics could be shifting, resulting in an increasing number of Medicare patients arriving at your facility in future.
It is not an easy task to find time in your busy schedule to stay on top of what's going on in Medicare in recent times. To help you with this we'll take a look at the proposed Medicare fee schedule adjustments expected for the next year.
Since 1992, the government has issued Medicare payments in accordance to the Physician Fee Schedule. Medicare generally offers payments at a single amount, dependent on a comprehensive list of resources the medical professionals utilize to provide services.
As per the Centers for Medicare and Medicaid Services, the PFS rate paid to physicians and others represents only a fraction of the resources utilized by the providers. For other services like tests for diagnosing, or procedures that are performed within radiation therapy facilities, the providers are generally involved in the technical aspects of billing, while the professional elements of services will be invoiced by the practitioner.
The following are some of the proposed changes to Medicare fees for the year 2023:
According to Medicare, “With the budget neutrality adjustments, as required by law to ensure payment rates for individual services don’t result in changes to estimated Medicare spending, the required statutory update to the conversion factor for CY 2023 of 0%, and the expiration of the 3% increase in PFS payments for CY 2022, the proposed CY 2023 PFS conversion factor is $33.08, a decrease of $1.53 to the CY 2022 PFS conversion factor of $34.61.”
For the professionals looking to get an update from CMS on split/shared E/M visits, “For CY 2023, we are proposing to delay the split (or shared) visits policy we finalized in CY 2022 for the definition of substantive portion, as more than half of the total time, for one year with a few exceptions.”
An important aspect of Medicare new changes is that the government is encouraging telehealth sessions by extending waivers for another period of 156 days. This is indeed good news for all the patients that are suffering or recovering from the pandemic and must continue to stay inside.
Moreover, CMS is proposing changes that will allow advanced payments to certain accountable organizations, resulting in assisting in providing care services to the populations that are at high-risk and have very few medical resources.
With the latest changes of Medicare's fee schedule scheduled to take effect in 2023, it is the perfect time to look over any practice management system you have installed and the balance sheet of your business. Of course, you'll be looking to ensure that you are always able to access up-to-date information on changes in the field of healthcare, such as fees and regulations. Keep an eye on this blog and feel free to reach us anytime for any concerns or questions about Medicare payments.
This guide provides a detailed view on the upcoming fee changes for the year 2023. Due to the novel corona virus, the government is encouraging telehealth services for another 5 months. The CMS is also promoting health services to the population that is at high-risk. To know more about the insights on Medicare, make sure to follow us and we will deliver all the core information you are looking for.