In recent years when there are planned cuts to the Medicare Conversion Factor (CF) Congress will take action to mitigate the cuts in a year-end spending package. However, this year it was not addressed, leaving physicians with lower Medicare reimbursement rates to start the new year. The CF’s 3.37% cut was finalized by the Centers for Medicare and Medicaid Services (CMS) in the 2024 Medicare Physician Fee Schedule (PFS) final rule. 

This reduction to the CF is largely due to budget neutrality adjustments which were predominantly caused by CMS beginning to cover add-on CPT code G2211. CMS had to offset the anticipated cost for covering this code with reductions elsewhere in the PFS. 

The 2024 CF reduction also includes a 1.25 percent reduction compared to 2023 as specified in legislation passed by Congress at the end of 2022, which instituted a 2.5 percent increase to the CF in 2023 and a 1.25 percent increase to the CF in 2024.

In December, the GOP Doctors Caucus, a group of Republican House Members who are physicians, led efforts to eliminate the CF reduction. Their efforts were unsuccessful. However, Congress had another opportunity to address these cuts in January when another spending bill had to be passed to prevent a government shutdown. Similar attempts continued during the development of the January spending package. Despite interest from both Republican and Democratic leaders, no agreement was reached.

The January spending bill only extended federal funding into March. Physicians will likely need to wait until this March spending bill for the next opportunity to address the CF reductions. The Senate Health, Education, Labor, and Pensions Committee is collaborating with the Senate Finance Committee on a new healthcare bill, which could serve as an alternative vehicle to mitigate some or all the cuts to the 2024 CF.

ADVOCATE will share additional information with clients and friends as it becomes available on this and other Federal Health Policies.

 

Kirk Reinitz, President