Medicare Releases Physician Fee Schedule Final Rule for 2022

The Center for Medicare and Medicaid Services (CMS) released its final rule for the Medicare Physician Fee Schedule (MPFS) for calendar year 2022. Earlier this year, the Endocrine Society provided detailed comments on the proposed rule. While we still have serious concerns, several of our recommendations to benefit endocrinologists were incorporated into the final rule.

For 2022, CMS finalized a conversion factor of $33.5983, which is a decrease of $1.2948 from the 2021 conversion factor of $34.8931. This reduction is largely the result of the expiration of the 3.75% conversion factor increase for 2021, which Congress approved in late 2020. Congress approved this cut to avoid a large reimbursement decrease during the public health emergency. Congress has the authority to mitigate this cut and the Society has been working closely with congressional offices to address this issue before the end of the year.

CMS also finalized other policies in the final rule important to the Society. CMS proposed to implement the clinical labor pricing inputs used to calculate the direct PE of services. We were pleased that CMS listened to our recommendation to phase in these new inputs over a four-year period, mitigating the immediate financial impact in 2022. The Society was pleased that CMS will continue to allow for services on their temporary telehealth list to remain until the end of 2023. We were also glad that CMS broadened its definition of “home” pertaining to delivery to telehealth services. The Society urged CMS to continue covering audio-only evaluation and management services after the public health emergency (PHE) concludes. Unfortunately, CMS did not change this policy putting audio-only coverage at risk at the end of the PHE. The PHE is expected to continue through at least the fall of 2022, and we will continue to advocate for audio-only to be made permanent. Finally, CMS did finalize its policy to make virtual check-in available permanently.

Throughout December, the Society will continue to strongly advocate for Congress to avert the Medicare cuts scheduled to take place next year. In addition to the MPFS conversion factor cut, there are two additional cuts scheduled to occur. Unfortunately, these cuts could result in almost a 10% cut in Medicare reimbursement on January 1, 2022. To avert these cuts, Congress must act, and the Society is urging Congress to prevent these cuts from taking place. We will launch an online grassroots advocacy campaign so that you can contact your members of Congress on this issue. Please stay tuned for more information at: www.endocrine.org/advocacy.