CMS Releases the 2024 Final MPFS and OPPS Rules

CMS released both the 2024 MPFS and OPPS Final Rules on Thursday.  Both Rules formally adopt many major changes for the upcoming year including:  

2024 MPFS

  • 3.4% decrease to the conversion factor (CF).  The new CF is $32.74, a decrease of $1.15 form the current 2023 CF of $33.89 
  • Implementation of G2211 (visit complexity add-on)
  • Adoption of the AMA CPT revised guidelines that define “substantive portion” for split/shared visits 
  • Additional implementation delay for Appropriate Use Criteria (AUC)
  • Continued coverage and payment of telehealth services, as well as continued permissions of direct supervision through real-time audio and video until December 31, 2024
  • Continued allowance of teaching physicians to use audio/video real-time communications technology to be present when supervising residents
  • Expansion of behavioral health services, including coverage and payment for the services of marriage and family therapists (MFTs) and mental health counselors (MHCs) and allow them to enroll and bill starting January 1, 2024

2024 OPPS 

  • 3.1% payment increase for eligible hospitals
  • Establishment of an intensive outpatient program (IOP) for mental and behavioral health services, as well as substance abuse services
  • Modification of certain aspects of the price transparency requirements which require hospitals to display standard charges using a CMS template format (see special Fact Sheet link below)
  • Adoption of new quality measures

We recommend reading the entire Final Rule in order to identify all the changes applicable to your practice.  These changes are significant and will require some swift action.  We recommend the following to assist with successful implementation:

  • Educate your clinical, coding and billing staff on the rules 
  • Update documentation templates
  • Update your charge description masters and internal billing system edits
  • Update documentation and coding policies and procedures

The 2024 MPFS Final Rule is located here:

The 2024 MPFS Fact Sheet is here:

The 2024 OPPS Final Rule is located here:

The 2024 OPPS Fact Sheet is here:

Hospital Price Transparency Fact Sheet:

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