CMS Releases 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 (PFS) and Other Revisions to Medicare Part B [CMS-1770-P] Proposed Rule, which includes proposals related to Medicare physician payment and the Quality Payment Program (QPP). Physicians face large, proposed cuts of more than 4% under this year’s fee schedule, along with significant proposed changes to Accountable Care Organizations (ACOs), the launch of the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs), updates to telehealth services, initiatives promoting health equity and other changes to further develop physician quality initiatives.

Key takeaways from the CY 2023 PFS Proposed Rule:

  • Proposes a 2023 physician conversion factor (CF) of $33.0775, representing a 4.4% reduction from the 2022 CF of $34.6062
  • Would implement the statutory extension of coverage for certain telehealth services to 151 days after the end of the public health emergency (PHE)
  • Would begin the new MVPs track as a voluntary option to the MIPS in 2023 with 12 different pathways
  • Proposes changes to the Medicare Shared Savings Program (MSSP) and introduces new advance investment payments intended to achieve the Administration’s goal of 100% participation in accountable care relationships by 2030
  • Outlines policies to make behavioral health care easier to access, including addressing the shortage of behavioral health practitioners
  • Continues the emphasis on health equity, including how to weave equity into CMS quality reporting programs.

Comments on the proposed rule are due by September 6, 2022.

Read on for a topline summary of the major provisions in the proposed rule.

  • The proposed regulation is available here.
  • The press release is available here.
  • The fact sheet on payment policies is available here.
  • The QPP factsheet is available here.
  • The MSSP factsheet is available here.
  • CMS also issued a blog post on the proposed behavioral health changes.

Click here to download the detailed summary of the key provisions in the proposed rule.