ED Coding and Reimbursement Alert

Final rule makes conversion factor even lower.

People who wanted the Centers for Medicare & Medicaid Services (CMS) to change its proposed conversion factor (CF) for 2023 got their wish.

In a classic case of be careful what you wish for, the Medicare Physician Fee Schedule (MPFS) final rule posted on Nov. 1, and the coding community is already fretting about how the CF will affect the bottom line next year.

Here’s the 2023 Conversion Factor

For 2023, the final MPFS CF is $33.06, a decrease of 4.5 percent (or $1.55) from the CY 2022 MPFS conversion factor of $34.60.

The 2023 MPFS CF is actually a higher decrease than the proposed 4.4 percent decrease put forth in the proposed final rule, according to a release from the American College of Emergency Physicians (ACEP).

“We were hoping that CMS would finalize a smaller cut to the PFS conversion factor than the 4.4 percent reduction the agency proposed. Unfortunately, despite our comments, CMS wound up doing the exact opposite and finalized a slightly higher reduction,” ACEP reports.

All is not lost however. Congress could step in before the end of the year and change the conversion factor. Whether it will remains to be seen, but there will be pressure on Congress to act, ACEP says.

“It’s now officially up to Congress to take action to avert this cut. … ACEP will continue making this issue one of its top legislative priorities, and we are hopeful that Congress will include some sort of fix in a year-end package,” according to ACEP.

Look for more information on the MPFS final rule in future issues of ED Coding & Reimbursement Alert.