On the heels of the omnibus spending bill that President Biden signed into law Dec. 29, CMS has taken up one of its imperatives to scale down the reduction in Medicare payments. The agency posted a revised conversion factor of $33.8872, replacing the $33.0607 amount originally released with the final 2023 Medicare physician fee schedule.
While CMS has yet to make a formal announcement about the conversion factor update,
Part B News located the new figure in the "CY 2023 PFS Final Rule Impact on Payment for Selected Procedures" file that's part of
the supplementary materials the agency lists among its fee schedule addenda.
The updated rate computes to a 2.1% drop in the CF amount between 2022 and 2023, well below
the expected 4.5% decrease that was on the books had Congress not intervened. The 2.1% drop also is an improvement over
the 2.5% cut that lawmakers touted and appears to lift reimbursement out of that hole by 2.4%, although other potential cost factors remain to be seen.
The augmented conversion factor is expected to translate to significant changes in 2023 payment levels, as the "selected procedures" document indicates. Prior to congressional intervention, E/M office visit codes
99213 and
99214 were slated for a -4% and -3% cut, respectively, to the non-facility rate in 2023; under the revamped CF, the decrease will be a more muted -1%. Codes 99213 and 99214 were the #13 and #7 most-billed codes among professional fee providers in 2021, according to the latest available Medicare claims data.
Services that were on the rise, such as immunization administration code 90471, now get a bigger boost. The non-facility payment rate for 90471 shoots up 20% in 2023 under the new CF; previously it was up 17%. And those with modest decreases, such as the EKG code 93000 that was on the hook for a -2% drop, will now stay flat year-to-year.