The Centers for Medicare & Medicaid Services (CMS) released the 2024 final Physician Fee Schedule (PFS) on Nov. 2.
Overall payment rates in the PFS will decrease by 1.25 percent in 2024 compared with 2023. The final 2024 PFS conversion factor is $32.74, a decrease of $1.15 (or 3.4 percent) from the current 2023 conversion factor of $33.89.
The add-on code G2211 will be implemented to improve recognition of the resource costs associated with evaluation and management visits for primary care and longitudinal care. It will be applicable for outpatient and office visits as an additional payment. While this add-on code will have redistributive impacts on all other payments within the PFS due to budget neutrality requirements, the impact will be less than was originally estimated due to refinements in the original policy. These refinements to the policy include a requirement that the add-on code be focused on longitudinal care for all needed health care services or a single, serious, or complex condition. Additionally, in response to public feedback, CMS has refined its utilization estimates for the add-on code.
The finalized proposal also makes changes to the data reporting and payment requirements for clinical diagnostic laboratory tests (CDLTs). Among those changes are updated definitions to the “data collection period” and “data reporting period”; a requirement for data collection every three years; and the phase-in of payment reductions to reflect the amendments in Section 4114(a) of the Consolidated Appropriations Act (2023). For calendar year 2023, payment for a CDLT that is not an advanced diagnostic laboratory test may not be reduced compared with the payment amount established for that test in the preceding year. Additionally, for calendar years 2024 through 2026, payment may not be reduced by more than 15 percent as compared with the amount established for that test in the preceding year.
The finalized policy changes will be effective on Jan. 1, 2024.