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CY 2023 Physician Fee Schedule Proposed Rule

On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) released the CY 2023 Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B Proposed Rule, which was published in the Federal Register on July 29, 2022.

The proposed rule includes proposals related to Medicare physician payment and the Quality Payment Program. Physicians face proposed cuts of more than 4% under the proposed fee schedule, along with significant proposed changes to accountable care organizations. The proposed rule also includes the following proposals:

  • Launch the Merit-based Incentive Payment System (MIPS) Value Pathways as a voluntary option to the MIPS in 2023.
  • Permanently maintain certain services added to the telehealth list during the PHE; maintain certain services added as covered telehealth services but not given permanent or Category 3 status until 151 days post-PHE and add several codes as Category 3 telehealth codes, which are slated to remain covered until the end of CY 2023.
  • Delay the in-person requirements for telehealth services furnished for purposes of diagnosis, evaluation or treatment of a mental health disorder until the 152nd day after the PHE ends.
  • Expand access to, and address shortages of, behavioral services and health providers by allowing licensed professional counselors and licensed marriage and family therapists to bill Medicare under general supervision, and create a new billing code for general behavioral health integration services for clinical psychologists and clinical social workers when they are the focal point of integration; and
  • Implement initiatives promoting health equity.

For additional analysis of the CY 2023 Medicare Physician Fee Schedule proposed rule, see McDermott+Consulting’s article.




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OIG Reports More than $731 Million in Inappropriate Medicare Meaningful Use Payments

Amanda Enyeart and Lisa Schmitz Mazur wrote this bylined article explaining how the HHS Office of Inspector General used a survey by the Electronic Health Records (EHR) Incentive Program run by Centers for Medicare and Medicaid Services (CMS) to conclude that CMS made $729 million in inappropriate EHR incentive payments to physicians out of some $6 billion in such payments during the review period.

Read the full article.




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