Cms Cuts Medicare Payments To Docs, Extends Telehealth Payments

November 8, 2021  by  Allzone MS   260

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The conversion factor per relative value unit under the 2022 fee schedule will be reduced to $33.59, down from $34.89 in 2021.

KEY TAKEAWAYS

CMS says that’s the result of the anticipated sunset of a temporary 3.75% payment increase in 2022, a 0% conversion update, and adjustments mandated by budget neutrality.

Physicians blasted the payment reductions and said the expected 3.75% payment sunset coupled with the mandated Medicare cuts mean that they will see nearly a 9% reduction in reimbursements.

The final rule also adds quality metrics designed to incentivize clinicians to improve outcomes for Medicare beneficiaries.

Physicians are staring at a nearly 9% cut in Medicare reimbursements in 2022, but telehealth payments will extend through at least 2023 under the 2022 Physician Fee Schedule made public late Tuesday by the Centers for Medicare & Medicaid Services.

CMS Administrator Chiquita Brooks-LaSure says the final rule will promote greater use of telehealth for behavioral healthcare, encourage growth in diabetes prevention and boost payments for vaccine administration.

“The COVID-19 pandemic has highlighted the gaps in our current healthcare system and the need for new solutions to bring treatments to patients, wherever they are,” Brooks-LaSure said. “This is especially true for people who need behavioral health services, and the improvements we are enacting will give people greater access to telehealth and other care delivery options.”

The final rule also adds quality metrics designed to incentivize clinicians to improve outcomes for Medicare beneficiaries.

Acting on legislation passed by Congress last year, CMS is eliminating geographic barriers and allowing patients to access telehealth services in their homes for diagnosis, evaluation, and treatment of mental health disorders.

For physicians, the conversion factor per relative value unit under the 2022 fee schedule will be reduced to $33.59, down from $34.89 in 2021, a drop of $1.31, which CMS said is the result of the anticipated sunset of a temporary 3.75% payment increase in 2022, a 0% conversion update, and adjustments mandated by budget neutrality.

The American College of Surgeons blasted the payment reductions and said the expected 3.75% payment sunset coupled with the mandated Medicare cuts mean that surgeons will see nearly a 9% reduction in reimbursements.

“Surgeons and their patients have already been significantly impacted by the pandemic,” ACS Executive Director David B. Hoyt, MD, said. “These Medicare cuts will further exacerbate our pandemic-strained health care system and cause further delay in care to the patients who need it most.”

CMS has also delayed by at least one year the penalties for Appropriate Use Criteria. The penalty phase was supposed to begin on Jan. 1, 2022, but it’s been pushed back to either Jan. 1, 2023, or the Jan. 1 that follows the end of the COVID-19 public health emergency.

For the Quality Payment Program, CMS will implement seven optional Merit-based Incentive Payment System Value Pathways, starting in 2023. MVPs align the reporting requirements of the four MIPS performance categories around specific clinical specialties, medical conditions or episodes of care. CMS also will increase the MIPS performance threshold score clinicians and groups must exceed to receive positive payment adjustments beginning with CY 2024 payment..

For More Information: https://www.healthleadersmedia.com/finance/cms-cuts-medicare-payments-docs-extends-telehealth-payments