On Demand - 2024 Proposed Medicare Physician Fee Schedule (MPFS) and Medicare Hospital Outpatient Prospective Payment (HOPPS) Rules: Impacts to Cardiology-Presentation Slides

Presentation Slides

Pdf Summary

The proposed Medicare Physician Fee Schedule (MPFS) and Hospital Payment Rules for 2024 are expected to have several impacts on cardiology. The conversion factor for physicians is set to decrease by 3.36% from $33.89 to $32.75, resulting in a flat overall reimbursement for cardiovascular services compared to 2023.<br /><br />Some of the proposed changes include the pause of the implementation of the Appropriate Use Criteria (AUC) Program for reevaluation and the postponement of the split/shared billing changes until at least Dec. 31, 2024. Advanced practice practitioners may now supervise cardiac rehabilitation, intensive cardiac rehabilitation, and pulmonary rehabilitation.<br /><br />Telehealth services will continue to be available, but Medicare does not propose adding cardiovascular and pulmonary rehabilitation services to the Medicare Telehealth Services List. A new add-on code for visit complexity is proposed, applicable in the office or outpatient setting.<br /><br />New initiatives include the coverage of caregiver training services, community health integration services, and social determinants of health services. These initiatives aim to improve patient-centered care, address social factors impacting health, and enhance access to care and outcomes.<br /><br />The Quality Payment Program (QPP) will include new measures for heart disease and other conditions, as well as adjustments to the program scoring. Additionally, changes are proposed for the Medicare Shared Savings Program (MSSP) to refine benchmark updates and increase collaboration with community-based organizations.<br /><br />The Outpatient Prospective Payment System (OPPS) is projected to have a 2.8% increase in rates, with some changes to specific services and codes. Advocacy efforts are ongoing, including surveys, legislative initiatives, and participation in the AMA Physician Practice Information Survey.<br /><br />Overall, the proposed MPFS and Hospital Payment Rules for 2024 aim to address various aspects of cardiology reimbursement, telehealth services, and patient-centered care while promoting equity and improved outcomes.

Keywords

Medicare Physician Fee Schedule

cardiology

reimbursement

telehealth services

add-on code

visit complexity

caregiver training services

social determinants of health services

Quality Payment Program

Outpatient Prospective Payment System