Medicare Compliance & Reimbursement

Plus: CMS holds up on using revised MEI cost weights in the 2023 ratesetting.

With the conversion factor (CF) slated for a major cut next year, you are probably concerned about how that will impact your bottom line. Some specialties will fare better than others, according to the calendar year (CY) 2023 Medicare Physician Fee Schedule (MPFS) final rule, which is scheduled for publication in the Federal Register on Nov. 18.

The Centers for Medicare & Medicaid Services (CMS) always estimates which specialties will be positively and negatively affected by the annual budget neutrality requirements to the CF and subsequently the changes to relative value units (RVUs). Here’s a breakdown of the 2023 top winners and losers from the Table 148 on page 2,265 of the unpublished final rule:

(Source: TABLE 148: CY 2023 PFS Estimated Impact on Total Allowed Charges by Specialty; www.federalregister.gov/public-inspection/2022-23873/ medicare-and-medicaid-programs-cy-2023-payment-policies-under-the-physician-fee-schedule-and-other)

Understand CMS Decision on MEI Weighting

In the CY 2023 proposed rule, CMS suggested rebasing and revising the Medicare Economic Index (MEI) and asked for the public’s input about using 2017-based MEI weights in calculating geographic practice cost indices (GPCIs). The agency did follow through and “rebase and revise” the MEI cost weights; however, they chose not to use the new methodology in CY 2023 ratesetting but hope to use the data to “calibrate payment rates and update the GPCI” in future MPFS rules, says a CMS fact sheet.