Advocacy Update

Nov. 5, 2021: Advocacy Update spotlight on final rule for 2022 Medicare physician fee schedule

. 2 MIN READ

The Centers for Medicare & Medicaid Services (CMS) released the final rule for the CY 2022 Medicare physician fee schedule. In a statement after the rule’s release, Dr. Harmon noted that the rule confirms the cuts that are in store that Congress must address before the end of the year. "The AMA is strongly advocating for Congress to avert this and other looming cuts to Medicare physician payments that, overall, will produce a combined 9.75 percent cut for 2022. This comes at a time when physician practices are still recovering the personal and financial impacts of the COVID public health emergency. Congress is beginning to recognize that this financial instability could limit health care access for Medicare patients. The clock is ticking."

Notably, the 2022 Medicare conversion factor will be reduced by approximately 3.85% from 34.8931 (2021) to 33.5983. This is largely a result of the expiration of a 3.75% increase to the conversion factor at the end of calendar year 2021, as averted in 2021 by Congressional action. AMA also points out that the “impact table in the proposed rule does not seem to include the 3.75 percent reduction in the conversion factor.”

Additionally, CMS finalized provisions that extend coverage of services that were added to the Medicare telehealth list on an interim basis in response to the COVID-19 PHE until the end of 2023 and eliminated geographic barriers, allowing patients in their homes to access telehealth services for diagnosis, evaluation and treatment of mental health disorders. CMS also announced plans to permanently increase payment for immunization administration, beyond COVID vaccines and relied on information from the AMA and the RUC in developing the improved payment rates. CMS is also moving forward with the first round of seven MIPS Value Pathways (MVPs) that will be available, beginning with the 2023 performance year.

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