Tuesday, November 7, 2023

Psychiatrists, Patients See Important Gains in 2024 Medicare Physician Fee Schedule

APA advocacy scored important victories for psychiatrists and patients in the 2024 Medicare Physician Fee Schedule, released by the Centers for Medicare and Medicaid Services (CMS) last week. These include policies regarding physician reimbursement, outpatient telepsychiatry, MIPS (Merit-Based Incentive Payment System) reporting, and virtual supervision of trainees. The new policies will go into effect January 1, 2024.

Importantly, CMS accepted APA’s recommendation to increase the relative value units (RVUs) for psychotherapy codes used alongside a code for an evaluation and management (E/M) services by approximately 19.1%, phased in over four years. For 2024, this will result in an increase in payment for psychotherapy visits of between $3 and $6.

Additionally, CMS approved a new E/M add-on code (G2211), which can be used in addition to codes for outpatient E/M services to recognize the resource costs associated with care of patients with chronic or complex conditions.

The 2024 fee schedule also includes good news for psychiatrist in the following areas:

  • CMS extended through 2024 the current temporary policy to reimburse outpatient telepsychiatry in the patient’s home (code POS 02) at the same rate as in-person care. (The patient’s home can include temporary lodgings or other community-based settings.)
  • Medicare practitioners may continue to report their practice location instead of home address when providing telehealth services from their homes.
  • Payment for telehealth services delivered by Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) without a prior in-person visit will be extended through 2024.
  • Through 2024, resident physicians can continue to be virtually supervised when they are delivering telehealth—an important APA advocacy priority. However, in-person care delivered by residents must still be supervised in person, and resident training sites should be prepared to provide in-person supervision beginning in January. (An exception to this is if the resident and patient are in rural areas; in which case virtual supervision is permitted.) This issue will continue to be an APA priority for the 2025 Medicare fee schedule.
  • CMS will maintain the MIPS reporting threshold for neutral payment adjustments at 75% for an additional year, alleviating the pressure to increase MIPS reporting.
  • CMS payment for audio-only periodic assessments in opioid treatment programs is extended through 2024.
  • Services in intensive outpatient programs (IOP) will be covered when delivered by hospital outpatient departments, community mental health centers, RHCs, and FQHCs.

To learn more about what this news might mean for psychiatrists, register to attend APA’s 30-minute live discussion of 2024 Medicare Physician Fee Schedule & Telehealth Policy Updates next Thursday, November 16, starting at noon.

For more information, also see the 2024 Physician Fee Schedule fact sheet and look for additional coverage in the December issue of Psychiatric News.

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