2022 Medicare physician billing rates are now finalized after Congress disallowed most of the proposed 9.75% CMS cuts. The “Protecting Medicare and American Farmers from Sequester Cuts Act” passed both Houses last week and was signed by President Biden.
This act provides the following relief.
- Delays the 4% cut for the PAYGO (pay-as-you-go) provision until 2023.
- Provides a 3% increase (instead of 3.75%) in the Medicare Physician Fee Schedule that begins January 1, 2022.
- Phases in the Sequester cut — with a 1% cut in the second quarter of 2020 and the full 2% cut to begin in July 2022.
In addition, it delays the radiation oncology payment model until 2023.
The cuts amount to 2% for the year but are spread “unevenly” throughout the year.
- 75% cut — 1st quarter
- 75% cut — 2nd quarter
- 75% cut — last half of 2022
The cuts are also “uneven” among physician specialties. RBMA estimates that diagnostic radiology will experience a 3% reduction in Medicare reimbursements while interventional radiology will experience a larger reduction.
Howard Fleishon, chair of American College of Radiology’s Board of Chancellors, cautions that this legislation is a short-term fix and that Congress needs to “address the ongoing structural problems associated with Medicare’s broken payment system.”
CMS Radiation Oncology Model Delayed
The CMS Radiation Oncology (RO) project is intended to make site-neutral payments for certain radiation services. That model had already been delayed by a year and is now postponed until January 2023. The CMS RO model reduces reimbursement through bundling radiation therapy payments rather than paying for individual treatment episodes.
Oncology groups have warned that the mandatory model will lead to harmful cuts to radiation oncologists.
Clinical Lab Rate Cuts Postponed
Proposed payment cuts to the Clinical Laboratory Fee Schedule (CLFS) were postponed by one year, much as they were for 2021. A group of 22 lawmakers had recently written to House leadership pushing for a delay to the cuts, which were required under budget neutrality rules..
The American Clinical Laboratory Association (ACLA) and another 27 health organizations recently sent a letter to congressional leaders saying that the “harmful” cuts — 15% for some 600 common clinical lab tests and up to 23%— would negatively impact lab services that are “essential to the health and wellbeing” of millions of Americans who have chronic diseases, particularly seniors.