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CMS Publishes Proposed 2022 Medicare Physician Fee Schedule Rule

Wednesday, July 14, 2021 1:38 PM | Sydney Maras (Administrator)

The Centers for Medicare & Medicaid Services (CMS) has published the proposed rule for the 2022 Medicare Physician Fee Schedule (PFS). The proposed rule seeks to implement or receive public input on a number of payment and policy changes of interest including:

  • A 3.89% Reduction in the Medicare PFS conversion factor to comply with budget neutrality restrictions (Note: Congressional action averted budget neutrality cuts in the 2021 Medicare PFS)
  • Additional E/M updates to conform with the AMA CPT Codebook that took effect January 1, 2021
  • Further extension of temporary telehealth coverage initiated under the COVID-19 Public Health Emergency (PHE)
  • New regulations for expanded coverage of mental health services provided via telehealth and of audio-only telehealth
  • Direct billing authority for Physician Assistants as mandated by Congress
  • Provider input on vaccine administration practices and expenses
  • Continued authorization to provide Opioid Treatment Program (OTP) counseling and services via audio-only telehealth after the expiration of the PHE
  • Additional exceptions to and delayed enforcement of the electronic prescribing mandate for controlled substances prescribed to Medicare beneficiaries
  • Extension of the transition period for ACOs reporting electronic clinical quality measure/Merit-based Incentive Payment System clinical quality measures (eCQM/MIPS CQM)
  • Streamlining of the Shared Savings Program application process

More information on these and additional policy and payment changes under consideration is available on the CMS website. IMS staff are in the process of completing a comprehensive review of the 1,700-page rule. In consultation with the AMA and other stakeholders, we will be preparing written comments ahead of the September 13, 2021, submission deadline. Watch future IMS publications for additional information. Please contact Dennis Tibben in the IMS Center for Physician Advocacy if you have questions or would like to provide input on this proposed rule.


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