CMS Releases 2023 Medicare Physician Fee Schedule Proposed Rule

July 19, 2022 — On July 7, the Centers for Medicare & Medicaid Services (CMS) released the 2023 Medicare Physician Fee Schedule (PFS) proposed rule. In the days ahead the American Society of Nuclear Cardiology’s (ASNC) advocacy team will analyze the proposed rule and report to you on specifics that may impact your practice as well as any actions ASNC will take. CMS also posted a notice about the AUC Mandate.  

The society shared the following top-line analysis from these documents:  

Conversion Factor 

CMS’s proposed conversion factor for CY2023 is $33.08, which takes into account the statutorily required update to the conversion factor for CY2023 of 0 percent, the expiration of the 3 percent increase in PFS payments for CY2022 provided by Congress and the statutorily required budget neutrality adjustment to account for changes in relative value units. This conversion factor represents a decrease of $1.53 from the CY2022 PFS conversion factor of $34.61. 

If these conversion factor reductions are finalized, there will be payment cuts affecting services across the entire physician fee schedule. 

Stay tuned for payment charts compiling the CY2023 proposed Medicare PFS reimbursement rates for nuclear cardiology services. ASNC offers these valuable charts as a membership benefit. The advocacy team also will provide an analysis of the potential impact on nuclear cardiology reimbursement. 

Medicare Appropriate Use Criteria Program 

While the proposed rule is silent on the Medicare Appropriate Use Criteria (AUC) Program for advanced diagnostic imaging, CMS has provided notice that the payment penalty phase of the AUC Mandate will not begin January 1, 2023, even if the public health emergency for COVID-19 ends in 2022. 

CMS further states that, until further notice, the educational and operations testing period will continue and that CMS is “unable to forecast when the payment penalty phase will begin.”

CMS had previously finalized that the penalty phase of the AUC program would begin on January 1, 2023, or the first January 1 following the end of the COVID-19 public health emergency. 

For more information: www.asnc.org