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Payment cuts are in the offing for Part B providers in 2023, along with a series of other projected changes targeting E/M services, COVID-related billing flexibilities and value-based care, according to the proposed 2023 Medicare physician fee schedule released today.
 
After legislative reprieve buoyed fees in 2022, CMS again is taking a hack at its primary rate-setting mechanism. The proposed 2023 conversion factor is $33.08, down $1.53, or 4.4%, from the current-year conversion factor of $34.61, according to the 2,066-page proposed rule.
 
You've heard by now of the momentous changes coming to your office-based E/M codes in 2021. And perhaps you caught wind of accompanying payment updates. But just how game-changing are the new payments?
 
Physicians may have a new tool at their disposal to find the lowest-priced drugs for patients should a proposed rule from CMS take effect as planned. The proposed rule, released Nov. 26, would require Part D plans to adopt a Real Time Benefit Tool that can alert providers to the current price of drugs available under a patient's coverage terms.
An anesthesia group noticed that it had stopped receiving payments from a major private payer. The practice couldn’t figure out what happened.
Two top health care analysts with KPMG talk about the new rule that proposes to push all Medicare Shared Savings Program (MSSP) participants to two-sided risk.

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