News from the AGA

Take action: Medicare rules


 

2022 Medicare payment rules contain both good and bad news for GI. First the bad news: GIs and other specialties face millions of dollars in cuts as Medicare finalized a 3.71% cut to the Physician Fee Schedule conversion factor, which could increase to near 9% if Congress doesn’t act.

Here are highlights from the 2022 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Department (HOPD)/Ambulatory Surgery Center (ASC) final rules.

Good news

  • Telehealth reimbursement continues through December 2023.
  • Medicare coverage changes from the Removing Barriers to Colorectal Cancer Screening Act were finalized and coinsurance reduction will start Jan. 1, 2022, with full phase out by 2030.

Bad news

  • A 3.71% cut to MPFS 2022 conversion factor, which could result in a up to 9% cut to our practices. Email your lawmaker now.
  • HOPD and ASC conversion factors will increase 2% for those that meet applicable quality reporting requirements.
  • New MPFS payments for peroral endoscopic myotomy (POEM) and some capsule endoscopy CPT codes not as high as expected.

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