CMS finalizes 2024 Medicare Physician Fee Schedule, keeps QPP performance threshold
On November 2, the Centers for Medicare & Medicaid Services (CMS) released the final 2024 Medicare Physician Fee Schedule outlining cuts to dermatologists and other specialties to offset increases to primary care physician services. The AADA has strongly opposed these payment cuts and is actively lobbying Congress to stop them before they take effect.
The final 2024 Medicare Physician Fee Schedule included important policy changes to fee-for-service payments and the Quality Payment Program (QPP).
Key changes included:
- The final 2024 conversion factor is $32.7375, about a 3.4% reduction from $33.8872, resulting primarily from a required budget neutrality adjustment.
- Overall, dermatologists will see a 1% payment cut, but the total impact could differ depending on the practice mix. The AADA will assess the impact on specific codes.
- AADA advocacy led to a crucial win by permitting physicians to continue to use their practice location instead of their home address when providing telehealth services from their home.
- Due to AADA advocacy, the MIPS performance threshold will remain at 75 points for the performance year 2024, as opposed to the 82 points that were proposed.
- Because of AADA’s efforts, CMS did not finalize an increase to the data completeness threshold for the 2027 performance year.
- Unfortunately, CMS finalized the evaluation and management complexity add-on code, G2211. According to CMS estimates, the G2211 code is responsible for about 90% of the budget neutrality reduction to the conversion factor. The G2211 code also restricts most dermatologists from using it, as billing with modifier 25 alongside the code is not permissible. The AADA and 40 other medical specialties urged Congress to act before the code goes into effect on Jan. 1, 2024. Without congressional intervention, many physician specialties and non-physician clinicians will face cuts in reimbursement.
- CMS will reimburse the higher non-facility rate for telehealth services provided to patients seeking care from their home.
- CMS will continue to provide coverage and payment of telehealth services included on the Medicare Telehealth Services List through 2024.
- CMS removed measures 138 (Melanoma: Coordination of Care) and 402 (Tobacco Use and Help with Quitting Among Adolescents) for reporting.
The AADA strongly opposes the cuts and is actively lobbying Congress to take action to eliminate them before the end of the year. The AADA is also eagerly monitoring the introduction of the draft legislation, the Provider Reimbursement Stability Act of 2023, which addresses the budget neutrality policies resulting in annual cuts to physician payment. The draft bill was discussed at a recent Congressional hearing on Medicare Payment.
Alleviating the cuts for 2024 and securing a long-term solution to the Medicare payment crisis is the AADA’s top advocacy priority. Urge Congress to back H.R. 2474 for inflation-based increases in 2024 and beyond by contacting your representatives now.
AADA members are encouraged to ask their patients to urge Congress to act. You can use this flyer that has talking points and a QR code to direct them to the Patient Action Center.
The AADA staff is reviewing the almost 1,600+ page rule and will prepare an analysis of the policies featured in upcoming issues of DermWorld Weekly and AAD.org.
For more information, please review:
