On November 2, 2021, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 Revisions to Payment Policies under the Physician Fee Schedule (PFS) and Other Changes to Part B Payment Policies [CMS-1751-F] Final Rule, which includes policies related to Medicare physician payment and the Quality Payment Program (QPP). This year’s final rule addresses telehealth and other COVID-19 flexibilities, updates to the underlying practice expense (PE) data that will impact payment rates, health equity, and enhancements and other changes to further develop physician quality initiatives.
These regulations reflect the goals and priorities of the Biden Administration. The final rule focuses on extending COVID-19 flexibilities and payment enhancements into 2022 and establishing policies that takes health equity into account. The PFS regulations are also a vehicle to implement several payment and related policies from recent legislation.
Key takeaways from the CY 2022 PFS Final Rule:
- The 2022 physician conversion factor (CF) is $33.5983. This represents a decrease of 3.71% from the 2021 CF of $34.8931. The 2022 anesthesia CF is $20.9343, in comparison to the 2021 CF of $21.5600, representing a decrease of 2.9%.
- Coverage for services temporarily added to the Medicare Telehealth Services List during the pandemic is extended from the end of the public health emergency (PHE) to the end of CY 2023.
- Clinical labor pricing data will be updated over a four-year period. This will help maintain stability by gradually phasing in the new data and will reduce the near-term impact on specialties experiencing negative effects due to the new data.
- Payment for services provided by physical therapy assistants and occupational therapy assistants (supervised by physical therapists or occupational therapist) is set at 85%, as required by statute.
- Enhanced payments for COVID-19 vaccine administration will continue through CY 2022.
- The Merit-based Incentive Payment System (MIPS) Value Pathways will launch in CY 2023.
- The final regulations are available here.
- The press release is available here.
- The fact sheet is available here.
- The QPP factsheet is available here.
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For more information, contact Aaron Badida, Deborah Godes, Lauren Knizer, Tatyana Mallory, Sheila Madhani, Mara McDermott, Jennifer Ohn, Erica Stocker and Devin Stone.