Released on Jan 5, 2023

Congress Provides Physician Payment Cut Relief - 2% Cut Remains

Last month, the Senate passed an end-of-year spending deal that provides modest relief to a 2023 Medicare physician fee schedule cut. The House is expected to pass the bill and send it to President Biden.

Effective Jan. 1, 2023, the Medicare conversion factor — the starting point for calculating physician payments — will be cut by just over 2 percent.

“While ASGE is grateful Congress is poised to provide some relief, it is disappointing lawmakers did not stop the full extent of the cut,” said ASGE President Bret Petersen, MD, MASGE.

In November, the Centers for Medicare and Medicaid Services finalized a 4.5 percent reduction to the conversion factor, the majority of which was due to the expiring positive payment adjustment first provided by Congress for 2021, and renewed for 2022, to prevent a payment cut due to changes in evaluation and management codes.

ASGE called on Congress to not stop short of preventing the full 4.5 percent cut. Ultimately, lawmakers decided to phase out the positive payment adjustment, even as physician payment rates have fallen behind rising medical inflation.

For 2023, Congress is on the cusp of providing a 2.5 percent positive adjustment. That adjustment will be halved in 2024. Even with that relief, physicians will still receive a payment cut next year, and likely in 2024 as well. The spending deal does push off the threat of an added 4 percent Medicare sequester for another two years.

“The Medicare physician payment system is broken,” said Dr. Petersen. “Next year ASGE commits to working with its partners in the medical community and congressional lawmakers to restore payment predictability, fairness and stability to physician practices.”

Medicare Physician Payment 2021-2024

Year Base Conversion Factor 1-Year Statutory Adjustment Final Conversation Factor Year-Over-Year Percent Change
(or physician payment cut)
2021  3.75% 34.8931  
2022  3.0% 34.6062 -0.82%
2023  33.0607 2.5% 33.8872 -2.08%
2024  33.0607
 
 Subject to any changes to the CY2024 PFS final rule that could trigger budget neutrality adjustments
1.25% 33.4740 -1.22%
 
(minimum expected cut)

About Gastrointestinal Endoscopy
Gastrointestinal endoscopic procedures allow the gastroenterologist to visually inspect the upper gastrointestinal tract (esophagus, stomach and duodenum) and the lower bowel (colon and rectum) through an endoscope, a thin, flexible device with a lighted end and a powerful lens system. Endoscopy has been a major advance in the treatment of gastrointestinal diseases. For example, the use of endoscopes allows the detection of ulcers, cancers, polyps and sites of internal bleeding. Through endoscopy, tissue samples (biopsies) may be obtained, areas of blockage can be opened and active bleeding can be stopped. Polyps in the colon can be removed, which has been shown to prevent colon cancer.

About the American Society for Gastrointestinal Endoscopy
Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal endoscopy. ASGE, with almost 15,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit Asge.org and ValueOfColonoscopy.org for more information and to find a qualified doctor in your area.

 

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