2022 Final Medicare Physician Fee Schedule

CMS has released the 2022 Final Physician Fee Schedule. The release contains many notable provisions which will become effective on January 1, 2022 as well as some implementation delays to certain aspects of the split/shared rule changes. Highlights include:

• Conversion factor of $33.5983 (Decrease from 2021)
• Adoption of new codes to report chronic care and principal care management
• Clarification of teaching physician billing requirements for E/M services
• Payment methodology revisions for physical and occupational therapy services rendered in whole or in part by an aide
• Appropriate use criteria reporting revisions
• Significant changes to split/shared services, including critical care
• Direct billing and payment provisions for physician assistants

We recommend you review the entire rule to identify all of the changes applicable to your organization. We will be providing more detailed analysis in the upcoming days.

The Final Rule is available here: https://www.federalregister.gov/public-inspection/2021-23972/medicare-program-cy-2022-payment-policies-under-the-physician-fee-schedule-and-other-changes-to-part

The Fact Sheet is available here: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2022-medicare-physician-fee-schedule-final-rule

HBE’s team of coding and compliance experts is available to assist you with external reviews of your documentation, coding and reimbursement. Additionally, we can provide customized documentation and coding education and training for your clinical and coding staff. We are also available to provide assistance with conducting risk assessments, internal investigations and policy and procedure development.

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