Cardiologists, electrophysiologists ‘disappointed’ in final 2023 Medicare Physician Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) published its final rule for the 2023 Medicare Physician Fee Schedule (MPFS) on Nov. 1. The final conversion factor is $33.06, down from 2022’s conversion factor of $34.61, and reimbursements for cardiology are expected to decrease by approximately 1%. Also, the 3% supplemental increase included in the 2022 MPFS has been eliminated.

The American College of Cardiology (ACC) and Heart Rhythm Society (HRS) have issued a statement highlighting their disappointment with the finalized 2023 MPFS. ACC President Edward T.A. Fry, MD, and HRS President Andrew D. Krahn, MD, both signed the joint statement.

The groups’ most immediate concern is related to the updated relative value units (RVUs) for supraventricular tachycardia (SVT) ablation, ventricular tachycardia (VT) ablation and atrial fibrillation (AFib) ablation. CMS did increase the RVUs for those services in the final rule compared to its proposed rule, but the final RVUs still concern Fry, Krahn and their respective organizations.

A full breakdown of the final values for those services is available on the ACC website.

“While the changes CMS made in response to feedback from the ACC, HRS, members of Congress and other stakeholders are appreciated, ACC and HRS remain disappointed that the agency did not go further in amending the proposed cuts for key electrophysiology ablation services to reflect higher values derived within the established AMA/Specialty Society RVS Update Committee (RUC) survey process, recognizing the high degree of skill and lengthy period of training required to perform these complex services, the enhanced safety despite increasingly sick patients, improved quality outcomes, and greater clinical value,” the two groups wrote. “These ongoing cuts, as well as structural cuts to all Medicare services, continue to threaten patient access to important, high value cardiovascular services and underscore the need for not just short-term fixes, but long-term overarching reimbursement reform.”

No other ablation services RVUs were changed compared to the 2022 MPFS final rule.

A few other medical groups have also shared initial reactions to the 2023 MPFS final rule, and additional organizations will likely share their own thoughts in the days and weeks ahead.

The American Medical Association (AMA), for example, issued its own statement on the CMS announcement.

“The Medicare payment schedule released today puts Congress on notice that a nearly 4.5% across-the-board reduction in payment rates is an ominous reality unless lawmakers act before Jan. 1,” wrote AMA President Jack Resneck Jr., MD. “The rate cuts would create immediate financial instability in the Medicare physician payment system and threaten patient access to Medicare-participating physicians. The AMA will continue working with Congress to prevent this harmful outcome.”

More information from CMS is available here. Also, the full final rule can be read as a PDF here.

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