News
ASAM Summary of Major Provisions of CMS' Final 2024 Medicare Physician Fee Schedule Rule
On November 2, 2023 the Centers for Medicare and Medicaid Services (CMS) issued a final rule which revises CY 2024 payment policies under the Medicare Physician Fee Schedule (PFS) and makes other policy changes. CMS has also published a fact sheet on the 2024 Medicare Physician Fee Schedule Proposed Rule, available here. A summary of major proposed changes is provided below.
Read ASAM's full summary of the major provisions here.
Conversion Factor & Impact on Addiction Medicine Specialty
CMS finalized a CY 2024 Medicare conversion factor (CF) of $32.74, a decrease of $1.15 or 3.4 percent from the current 2023 CF rate of $33.89.
Per an analysis from the American Medical Association (AMA), the Addiction Medicine specialty is expected to see a 3% positive adjustment in allowed Medicare charges in 2024.
Visit complexity inherent to evaluation and management (G2211)
CMS finalized a proposal to implement a new add-on code (G2211) designed to better recognize the resource costs associated with evaluation and management visits for primary care and longitudinal care of complex patients. CMS noted that this code should be used in outpatient office visits, recognizing the inherent costs practitioners may incur when longitudinally treating a patient’s single, serious, or complex chronic condition.
Medicare Coverage of Marriage & Family Therapists, and Mental Health Counselors
The Consolidated Appropriations Act of 2023 defines Marriage and Family Therapist (MFT) services as services furnished by an MFT for the diagnosis and treatment of mental illnesses (other than services furnished to an inpatient of a hospital), which the MFT is legally authorized to perform under State law (or the State regulatory mechanism provided by State law) of the State in which such services are furnished, as would otherwise be covered if furnished by a physician or as an incident to a physician’s professional service.
The CAA also defines a as a person who:
- Possesses a master’s or doctor’s degree which qualifies for licensure or certification as a MFT pursuant to State law of the State in which such individual furnishes marriage and family therapist services;
- Is licensed or certified as a MFT by the State in which such individual furnishes such services;
- After obtaining such degree has performed at least 2 years of clinical supervised experience in marriage and family therapy; and
- Meets such other requirements as specified by the Secretary.