2024 Proposed Medicare Physician Fee Schedule

CMS outlines payment changes for 2024

On July 13, CMS released the 2024 Medicare Physician Fee Schedule proposed rule, which includes important policy changes to fee-for-service payments and the Quality Payment Program (QPP).

The proposed 2024 Medicare conversion factor would be reduced by about 3.4% from $33.8872 to $32.7476, resulting from a required budget neutrality adjustment. The AADA, working alongside the house of medicine, has succeeded in mitigating payment cuts for the last several years, but physicians need Congress to act to stabilize the Medicare payment system. 

According to the American Medical Association (AMA) specialty impact tables, dermatology is expected to face an overall 1.87% payment reduction due to the policy changes in the proposed rule and the conversion factor decrease. However, the total impact could differ depending on individual practice mix.

The AADA evaluated the impact on dermatologic codes and estimates a decrease ranging from approximately 1.00-4.00% per code. The proposed payment rates for each code reflect the impact of various policy changes related to physician work, practice expense, and malpractice relative value units (RVUs).

The AADA has urged Congress to provide a permanent solution, and it is a top advocacy priority. AADA members can contact their representatives and urge them to provide an inflation-based increase in Medicare payments in 2024 and future years by cosponsoring H.R. 2474, the “Strengthening Medicare for Patients and Providers Act.” 

Other key proposed changes announced by CMS

• CMS proposed the implementation of Evaluation and Management (E/M) Complexity Add-on Code (HCPCS Code G2211), which will cause an adverse budget neutrality adjustment to the conversion factor.

• CMS proposed several telehealth-related provisions required under the 2023 Consolidated Appropriations Act, including the temporary expansion of the scope of telehealth originating sites for services furnished via telehealth to include any site in the United States where the beneficiary is located at the time of the telehealth service, including an individual’s home, through Dec. 31, 2024. 

• As a direct result of the AADA’s and other specialty societies advocacy efforts, CMS is soliciting comments from stakeholders regarding their policies on excluding coverage for certain drugs under Part B that are usually self-administered by the patient.

• CMS is proposing several policies changes to the QPP, including increasing the performance threshold in MIPS from 75 to 82 points for the 2024 MIPS performance period, with penalties still set at up to 9%.

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