The Centers for Medicare & Medicaid Services Nov. 2 released its calendar year 2024 final rule for the physician fee schedule. The rule will cut the conversion factor by 3.4%, to $32.74 in CY 2024, as compared to $33.89 in CY 2023. This reflects the expiration of the 2.5% statutory payment increase for CY 2023; a 1.25% statutory payment increase for 2024; a 0.00% conversion factor update under the Medicare Access and Children’s Health Insurance Program Reauthorization Act; and a budget-neutrality adjustment. 

As urged by the AHA, CMS addressed the fact that on Jan. 1 practitioners who render telehealth services from home would have been required to report their home address on enrollment and claims forms. The agency delayed this provision until Jan. 1, 2025, and solicits comments on the issue for future rulemaking.
 
In addition, the agency finalized a revised definition of the substantive portion of a split (or shared) visit. Specifically, for CY 2024, for purposes of Medicare billing, the definition of “substantive portion” means more than half of the total time spent by the physician and non-physician practitioner performing the split (or shared) visit or a substantive part of the medical decision-making.
 
CMS finalized its proposals to advance access to behavioral health services. First, CMS will implement regulations as directed by the Consolidated Appropriations Act of 2023 to create a new benefit category for marriage and family therapists and mental health counselors under Part B, who will be eligible to provide telehealth services and behavioral health integration services. CMS also established new payment codes for mobile psychotherapy for crisis services as required by the CAA. Separately, the agency will apply an adjustment to psychotherapy services payments billed with a new increased complexity code and will increase the payment rate for the substance use disorder bundle.
  
For the Quality Payment Program, CMS finalized the creation of five new, optional Merit-based Incentive Payment System Value Pathways for reporting beginning in 2024. CMS also finalized its proposal to increase the performance threshold score that MIPS participants must achieve to earn positive payment adjustments, but it will not increase the quality data completeness threshold as originally proposed. Finally, for the Advanced Alternative Payment Model track of the QPP, CMS will offer Advanced APM Incentive Payments in CY 2025 to those qualifying clinicians. This one-year extension of Advanced APM bonus payments at a reduced rate of 3.5% was required by the CAA. 
 
Lastly, the agency finalized its proposal to withdraw all regulations related to the Appropriate Use Criteria program, citing patient access and financial liability risks. The AHA supports CMS's decision to pause the program for reevaluation. 

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