Medicare Finalizes 2023 Payment and Quality Reporting Changes

Edited November 23, 2022

2023 Final Medicare Physician Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) released the final 2023 Medicare Physician Fee Schedule (PFS) on November 1st, which in addition to major payment implications.

There are two major impacts to Medicare Revenue for physicians in 2023:

• CMS released the final 2023 Medicare Physician Fee Schedule (PFS) on November 1st
  • Sets 2023 Medicare payment rates with a conversion factor of $33.067
    • This is a decrease of -4.47% over 2022 rates.
    • Radiology: 3% decrease
    • Interventional Radiology: 4% decrease
    • Nuclear Medicine: 3 % decrease
    • Radiation Oncology & Radiation Therapy Centers: 1% decrease
      • The formula used is Total RVUs x Conversion Factor
        • 2022 CF = $34.61
        • 2023 CF = $33.06
• Medicare PAYGO 4% Cuts – The statutory Pay-As-You-Go (PAYGO) rules were automatically triggered due to an increase in the federal deficit.
  • The Medicare 4% pay-as-you-go (PAYGO) cut set to occur on January 1, 2022, was delayed for one year until 2023.
  • While Congress ultimately passed legislation that prevented this 4% PAYGO cut from taking effect in 2022, it only delayed the cut until 2023.
  • These cuts will begin in 2023, unless Congress intervenes. RBMA’s Federal Affairs Committee recently met with representatives of Congress to advocate for a solution to ensure that providers have the resources they need to keep their doors open for seniors and families.
• What can you do?
  • Physicians and practice leaders can advocate through groups like RBMA’s Radiology Patient Action Network – submit feedback to Congress at https://www.dontcutdocs.com/
• The estimate of overall decrease in reimbursement is 8% on Medicare business. Payor contracts tied to current Medicare fee schedules will also be impacted by the PFS changes of 3 – 4%.