CMS Releases Final 2023 Physician Fee Reimbursements

Despite the input of healthcare facilities, physicians, and health-related associations and societies, the CMS Medicare Physician Fee Schedule (MPFS) for 2023 will see a reduction in the face of the highest inflation rates in 40 years.

The CMS conversion factor falls to $33.0067 in 2023 — down from $34.6062 in 2022 — resulting in approximately a 2% decline in payment rates for radiology, according to a breakdown by the American College of Radiology. The payment decline is about a percentage point less than ACR had predicted this past summer. Subspecialties will also experience a lesser impact than originally forecast:

• Interventional Radiology – a 3% decline rather than 4%
• Nuclear Medicine – a 2% decrease instead of 3%
• Radiation Therapy – a 1% decline, the same as initially forecast

CMS’s final document brought strong comments from major medical associations and societies. ACR commented, “If Congress does not intervene to extend the 3 percent increase provided by the Protecting Medicare and American Farmers from Sequester Cuts Act, the percent decreases mentioned above will be greater for CY 2023.”

Physicians’ groups across the United States have been vehement that the decline in conversion rate coupled with an anticipated 4% cut under Congress’ PAYGO law will be harmful to Medicare recipients. This law specifies mandatory cuts if federal spending reaches a certain level.

Anders Gilberg of the Medical Group Management Association shared the results of a recent survey, “These proposed cuts, coupled with the 4% PAYGO sequestration scheduled to take effect on Jan. 1, 2023, will have a detrimental impact on group practices, with 58% of recently surveyed groups indicating they are considering limiting the number of new Medicare beneficiaries served.”

Jerry Penso, president and CEO of the American Medical Group Association said of the proposed cuts, “While disappointed in CMS’s action, we also recognize that this is Congress’s problem to fix. This annual brinksmanship with Medicare payments is not sustainable and does not support better patient care. These cuts undermine AMGA members’ ability to best care for their patients and invest in the technology, infrastructure, and staff needed to transition to value-based care.”

CMS did increase clinical labor values for some radiology-related positions:

• Vascular Interventional Technologist – from 0.60 to 0.84
• Mammography Technologist – from 0.63 to 0.79
• CT Technologist – from 0.76 to 0.78

The American College of Radiologists is reviewing the MPFS proposed rule and will issue a comprehensive summary and tender comments to CMS before the comment period deadline.