The 2024 Consolidated Appropriations Act passed and signed on Saturday, March 23, 2024, increased of Medicare Conversion Factor from $32.7442 to $33.2875, an increase of slightly over $0.54.
Medicare & Reimbursement
Penn State Health Agrees To Pay Over $11 Million Due To Violations Of Medicare Rules & Regulations
By Adam Appleberry on
Posted in Articles, Medicare & Reimbursement
Penn State Health has agreed to pay $11,712,336 to settle allegations of civil liability from submitting improper claims to Medicare for Annual Wellness Visit services.
Penn State Health has voluntarily disclosed that between December 2015 and November 2022 claims were submitted to Medicare for Annual Wellness Visit services that were not…
2024 Medicare Physician Fee Schedule
By Michael Cassidy on
Posted in Articles, Medicare & Reimbursement
CMS issued the Final Rule for the 2024 Medicare Physician Fee Schedule (PFS) on November 2, 2023, for payments to be effective on or after January 1, 2024.
The overall payment rates under the PFS will be reduced by 1.25% in calendar year 2024.
The final PFS conversion factor will be $32.74…
2024 Medicare Physician Fee Schedule
By Michael Cassidy on
Posted in Articles, Medicare & Reimbursement
- An additional add-on code (G2211) to existing evaluation and management visits for complex patients to better recognize the resource costs
- A delay
Medicare Physician Fee Schedule Reductions Partially Offset
By Michael Cassidy on
Posted in Articles, Medicare & Reimbursement
The final “2023 Omnibus Bill” which is the spending bill passed by Congress and signed by President Biden at the end of 2022, provides partial relief from the scheduled Medicare Physician Fee Schedule Conversion Factor cuts.
As previously reported, the changes to the Medicare Physician Schedule Conversion Factor would have reduced physician reimbursement by 4.5%.…
Medicare Physician Fee Schedule Final Rule Summary: CY 2023
By Michael Cassidy on
Posted in Articles, Medicare & Reimbursement
Please click the link to view the Medicare Physician Fee Schedule Final Rule Summary for 2023.
Medicare Proposes 2023 Physician Pay Cuts
By Michael Cassidy on
Posted in Articles, Medicare & Reimbursement
On July 7, 2022, CMS released its proposed Medicare Physician Fee Schedule for 2023, which proposes physician fee schedule reductions via the Medicare Conversion Factor.
- The general Medicare conversion factor will be reduced by 4.4% from $34,61 to $33.08
- The anesthesia conversion factor will be reduced 3.9% from $21.56 to $20.72
The link is attached
2022 Medicare Rules for Facility-Based Split/Shared Visits
By Michael Cassidy on
Posted in Articles, Medicare & Reimbursement
There has been much discussion and controversy over the new CMS position on billing for split/shared services in facility settings.
As originally proposed, and starting in January 2022, if the service was shared among providers (such as physicians and physician assistants), the provider who performed the substantive portion of the visit would be the provider…
“Stark” Rules: Navigating Physician Leases and Subleases
By Michael Cassidy on
Under the Federal Ethics in Patient Referrals Act (more commonly known as “Stark”), if a physician[1] has a financial relationship with an entity, the physician may not refer patients to the entity for medical services payable by Medicare unless the financial relationship complies with the Stark safe harbors. Thus, entities that lease or sublease…
CMS Policy Summary: 2022 Medicare Physician Fee Schedule, Telehealth Originating Site Facility Fee and Services List, and Physician Assistant Billing
By Michael Cassidy on
In MLN Matters article MM 12159, CMS has published summaries of the following:
- Updates to payment policies and Medicare payment rates for services provided by physicians and non-physician practitioners (NPP)
- Updates to Medicare telehealth services and telehealth originating site facility fee payment amounts
- Billing for a physician assistant (PA) services