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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.
 
The AMA set off its own fireworks during the Independence Day weekend with the early release of new E/M guidelines that will be included in the 2023 CPT manual and take effect Jan. 1, 2023.
 
Practices that aren’t comfortable with the guidelines for office and other outpatient E/M visits may downcode their claims because they mistakenly believe it will protect them from audits. In addition, some private payers may automatically downcode high level claims.
 
Cigna’s plan for unbundled office visits is likely to increase your paperwork and and slow reimbursement.
 
 
 
Industry experts and coders alike will be pleased to see the inclusion of 69 new codes to further identify the stage of severity, as well as behavioral and psychological symptoms of dementia (BPSD).
 
These were included as part of the 1,176 new codes released June 10 with the FY2023 ICD-10 final code update. The code update also includes two hundred Tabular and Alpha Index changes. The CDC has also posted the FY2023 guidelines along with the code update. These changes will take effect Oct. 1.
 

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