Washington E-Newsletter

CMS Releases Final 2023 Medicare Physician Fee Schedule Final

On Nov. 1, the Centers for Medicare & Medicaid Services (CMS) released the final 2023 Medicare Physician Fee Schedule rule. Overall, neurosurgeons face a 4% decrease, due primarily to the expiration of temporary financial relief provided by Congress last year to mitigate steep payment cuts in 2022. In addition, neurosurgeons face a 4% Statutory Pay-As-You-Go Act sequester cut absent Congressional action.

Provisions of interest to neurosurgeons include:

  • Restoration of the American Medical Association/Specialty Society RVS Update Committee-passed values for interbody spine fusion CPT® codes 22630 and 22633.
  • A one-year delay of a new policy requiring physicians to see patients for more than half of the total time of a split or shared evaluation and management visit to bill for the service. For 2023, CMS will continue to allow physicians and qualified health care professionals to use medical decision making to determine the substantive portion of the split/shared visit.
  • Changes to relative weights of the fee schedule components (i.e., work, practice expenses and professional liability insurance (PLI) expenses) that will decrease the value of physician work and PLI expenses, thus leading to future reductions in neurosurgical payments. The final changes will reflect an updated practice expense data collection initiative currently underway.

A more detailed summary of the final rule will be forthcoming. In the meantime, click here for a press release about the final rule and here for a fact sheet.