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Highlights of CMS Proposed Changes to Physician Fee Schedule


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Get a head start on strategic planning for next year with up-to-the minute details on the proposed changes to the 2023 Physician Fee Schedule (PFS). Public comments are still open prior to the final rulemaking. This information will help you make informed decisions and guide your practice in a positive direction. Spend an hour with healthcare compliance and revenue cycle management expert, Taya Moheiser, for this up to the minute report on what proposals are being considered for the 2023 Physician Fee Schedule Rule.

New revisions are proposed to coding and documentation framework, including E/M code updates from the AMA to reduce administrative burdens. Review 2023 CPT code descriptors like new times, revised interpretive guidelines for level of MDM, and choice of MDM or time to select code level, and the elimination of history and exam to determine code level. If finalized, there would instead be a requirement for a medically appropriate history and exam.

  • The expiration of the 3% PFS increase means providers can expect a decrease in PFS in 2023. Possible reweighting of MEI cost shares could also change to payments among PFS services.
  • Other proposals in review will involve split or shared E/M visits, changes to Medicare telehealth, and new HCPCS codes and valuation for chronic pain management.
  • E/M changes could include new descriptor times, revised interpretive guidelines for levels of MDM, and choice of MDM or Time to select code level.
  • Replacement of history and exam to determine code level with a requirement for a medically appropriate history and exam.
  • Telehealth Services have several proposals related to Medicare telehealth services that involve process transitions at the end of the PHE.
  • Learn what's happening in 2023 with behavioral health services, chronic pain management and treatment services, opioid treatment programs, audiology and dental/oral health services.
  • Changes to colorectal screenings include reducing the minimum age payment limitation to 45 years.