Physician Fee Schedule Proposed Rule 2023 - Make Your Revenue Smarter

In this major proposed rule, CMS is proposing to establish RVUs for CY 2023 for the PFS to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This proposed rule also includes discussions and provisions regarding several other Medicare Part B payment policies. Specifically, this proposed rule addresses:

  • Determination of PE RVUs (section II.B.)
  • Potentially Misvalued Services Under the PFS (section II.C.)
  • Payment for Medicare Telehealth Services Under Section 1834(m) of the Act (section II.D.)
  • Valuation of Specific Codes (section II.E.)
  • Evaluation and Management (E/M) Visits (section II.F.)
  • Geographic Practice Cost Indices (GPCI) (section II.G.)
  • Determination of Malpractice Relative Value Units (RVUs) (section II.H.)
  • Non-Face-to-Face/Remote Therapeutic Monitoring (RTM) Services (section II.I.)
  • Payment for Skin Substitutes (section II.J.)
  • Proposal to Allow Audiologists to Furnish Certain Diagnostic Tests Without a Physician Order (section II.K.)
  • Proposals and Request for Information on Medicare Parts A and B Payment for Dental Services (section II.L.)
  • Rebasing and Revising the Medicare Economic Index (MEI) (section II.M.)
  • Requiring Manufacturers of Certain Single-dose Container or Single-use Package Drugs to Provide Refunds with Respect to Discarded Amounts (§§ 414.902 and 414.940)
    (section III.A.)
  • Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) (section III.B.)
  • Clinical Laboratory Fee Schedule: Revised Data Reporting Period and Phase-in of Payment Reductions, and Proposals for Specimen Collection Fees and Travel Allowance for
    Clinical Diagnostic Laboratory Tests (section III.C.)
  • Expansion of Coverage for Colorectal Cancer Screening and Reducing Barriers (section III.D.)
  • Removal of Selected National Coverage Determinations (section III.E.)
  • Modifications Related to Medicare Coverage for Opioid Use Disorder (OUD) Treatment Services Furnished by Opioid Treatment Programs (OTPs ) (section III.F.)
  • Medicare Shared Savings Program (section III.G.)
  • Medicare Part B Payment for Preventive Vaccine Administration Services (section III.H.)
  • Medical Necessity and Documentation Requirements for Nonemergency, Scheduled, Repetitive Ambulance Services (section III.I.)
  • Medicare Provider and Supplier Enrollment and Conditions of DMEPOS Payment (section III.J.)
  • State Options for Implementing Medicaid Provider Enrollment Affiliation Provision (section III.K.)
  • Requirement for Electronic Prescribing for Controlled Substances for a Covered Part D Drug under a Prescription Drug Plan or an MA-PD Plan (section 2003 of the SUPPORT Act) (section III.L.)
  • Medicare Ground Ambulance Data Collection System (GADCS) (section III.M.)
  • Proposal to Revise HCPCS Level II Coding Procedures for Wound Care Management Products (section III.N.)
  • Updates to the Quality Payment Program (section IV.)
  • Collection of Information Requirements (section V.)
  • Response to Comments (section VI.)
  • Regulatory Impact Analysis (section VII.)

Get the details in the Federal Register for July 29, 2022

 

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