Medicare finalizes physician fee schedule for 2022

The Centers for Medicare & Medicaid Services (CMS) released its final rule on the 2022 Medicare physician fee schedule on Nov. 2. Among the highlights for family physicians:

• CMS is phasing in a repricing of clinical labor as part of its practice expense relative value unit (RVU) methodology. The repricing will benefit services that are more heavily dependent on clinical labor, such as evaluation and management.
• CMS is increasing the relative value of chronic care management services.
• The final rule will nearly double Medicare Part B payment rates for administering influenza, pneumococcal, and hepatitis B vaccines, from roughly $17 to $30.
• CMS again delayed the payment penalty phase of the appropriate use criteria (AUC) program. The penalty phase was set to begin Jan. 1, 2022, but it will now begin Jan. 1, 2023, or the first Jan. 1 that follows the declared end of the COVID-19 public health emergency, whichever comes later.

On the downside, CMS set the 2022 conversion factor (i.e., the amount it pays per RVU) at $33.59, which is $1.30 less than the 2021 conversion factor.

There was also mixed news on telehealth. The final rule extended coverage for in-home tele-mental health services — including audio-only services — beyond the COVID-19 public health emergency. It also allows federally qualified health centers and rural health clinics to continue with telehealth after the public health emergency. But it did not provide the same extension to other types of telehealth.

Along with the final rule, CMS published a press release and fact sheet. The American Academy of Family Physicians' full summary of the final rule is available here.

— Kent Moore, Senior Strategist for Physician Payment

Posted on Nov. 4, 2021, by Kent Moore