On November 1, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Payment Schedule effective January 1, 2023. AANEM policy staff is diligently reviewing the 3,000+ page rule. Here are a few highlights:
· CMS finalized a new neuromuscular ultrasound (NMUS) code, 76883, for reporting real-time, complete NMUS of nerves and accompanying structures throughout their anatomic course, per extremity. This new code will allow NM physicians to bill much more specifically for the NMUS procedures that they perform.
· In the Proposed Rule, CMS did not agree with the RUC recommended values for the NMUS codes 76881 (ultrasound, complete joint, real-time with image documentation), 76882 (ultrasound, limited, joint, or other nonvascular extremity structure(s), real-time with image documentation), or the new NMUS code 76883 (described above). Instead, they proposed Relative Value Units (RVUs) that would have resulted in drastic cuts to the code family. Thanks to advocacy efforts from AANEM, the AMA, all of the involved specialty societies, and physician members, CMS did NOT finalize their proposed reductions and instead accepted the RUC recommended values for all three codes. This will result in an increased work RVU (wRVU) for all three codes.
· CMS finalized the 2023 Medicare conversion factor (CF) at $33.06, a decrease of $1.55 or 4.5% from the 2022 CF of $34.61. The decrease is largely the result of an expiring 3% increase funded by Congress through 2022. The additional approximate 1.6% decrease is the result of budget neutrality requirements. This decrease in the CF will result in reduced reimbursement for all physicians across all specialties that bill Medicare. AANEM, along with the AMA, and hundreds of specialty societies continue to advocate that Congress avert this payment cut, as well as implement an inflationary update for physicians before the end of the year.
Look for the upcoming AANEM Edge in February for a more detailed analysis of the policies updated in the Physician Fee Schedule and the Quality Payment Program that could impact AANEM members. If you have questions or concerns about the final rule, email the policy department at firstname.lastname@example.org.