RPA: Nephrologists will likely see up to a 1% decrease in pay under Medicare proposal
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Key takeaways:
- CMS proposes a 1.25% reduction in payments under the Medicare Physician Fee Schedule for 2024.
- Nephrologists could see up to a 1% cut in payment.
Payments to nephrologists will likely go down by 1% or stay the same under the proposed Medicare Physician Fee Schedule for 2024, according to an analysis by the Renal Physicians Association.
CMS released the proposed rule on July 13, and “the news [is] neutral to slightly negative for nephrology,” the RPA wrote in a message to members. “The 2024 conversion factor affecting all of medicine is proposed to be $32.75, a 3.3% reduction, and the specialty-specific [relative value units] RVUs for nephrology are projected to be reduced by 1%, all on the inpatient side,” the RPA wrote. “Positively, all of the outpatient and inpatient dialysis codes and evaluation and management codes either maintain their values or are slightly increased.”
According to a CMS press release, the proposed rule seeks to improve distribution of Medicare payments to all specialties. “At CMS, our mission is to expand access to health care and ensure that health coverage is meaningful to the people we serve,” CMS Administrator Chiquita Brooks-LaSure, said in the release. “CMS’ proposals in the proposed physician payment rule would help people with Medicare navigate cancer treatment and have access to more types of behavioral health providers, strengthen primary care, and for the first time, allow Medicare payment for services performed by community health workers.”
According to CMS, the overall proposed payment amounts under the Medicare Physician Fee Schedule would be reduced by 1.25% compared with the amount for 2023, but payments for visit services, such as primary care, would increase. CMS is also proposing to pay for “certain caregiver training services and separate coding and payment for community health integration services, which would include person-centered planning, health system coordination, promoting patient self-advocacy, and facilitating access to community-based resources to address unmet social needs that interfere with the practitioner’s diagnosis and treatment of the patient,” according to the release.
Earlier this year, the RPA and other medical organizations showed support for legislation that would revamp the process CMS uses to determine Medicare payments to physicians by tying payment to inflation as measured by the Medicare Economic Index. The aim of the Strengthening Medicare for Patients and Providers Act is to “address payment uncertainty affecting Medicare-participating physicians and avoid a possible physician shortage for Medicare beneficiaries,” legislators who introduced the bill said in a press release.
References:
2024 Medicare Fee Schedule Proposed Rule released; Nephrology RVUs reduced by 1%. RPA Weekly News. Published July 19, 2023. Accessed July 19, 2023.
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