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CMS Releases 2022 Medicare Physician Fee Schedule Proposed Rule

On July 13, 2021, CMS released the 2022 Medicare Physician Fee Schedule proposed rule. Overall, neurosurgery will receive a 3.2% payment cut in 2022. The cut stems from a lower conversion factor — from $34.89 in 2021 to $33.58 in 2022 — primarily due to the discontinuation of the 3.75% payment increase included in the Consolidated Appropriations Act, 2021. With the 2% Medicare sequester set to resume next year and additional Medicare payment cuts of up to 4% possible under pay-as-you-go rules to pay for the American Rescue Plan, providers could be facing up to 9% in payment cuts next year unless Congress intervenes.

In addition, CMS rejected the American Medical Association/Specialty Society RVS Update Committee (RUC) recommended work relative values (wRVUs) for new laser interstitial thermal therapy (LITT) codes and the new arthrodesis decompression add-on codes to report decompression when performed in conjunction with posterior interbody arthrodesis at the same interspace.

CPT Code

Descriptor

RUC-Passed wRVU

CMS Proposed wRVU

617X1

Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion

20.00

19.06

617X2

Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)

24.00

22.67

616X1

Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional segment

4.44

2.31

616XX

Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment

5.55

3.08

Finally, once again, CMS proposes to delay the effective date for the penalty phase of the Medicare AUC Program to either Jan. 1, 2023, or the first January following the end of the COVID-19 PHE, whichever is later.

Click here for a CMS press release that includes links to multiple fact sheets.