Late November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) released the final 2024 Medicare Physician Fee Schedule (MPFS) and 2024 Hospital Outpatient Prospective Payment System rules. The rules take effect January 1, 2024.
MPFS High-Level Take-Aways
- Payments decline: The November 2 final rule reports that the CY 2024 Conversion Factor (CF) is $32.7375, a decrease of 3.39 percent from the 2023 conversion factor of $33.8872. Mitigating this cut will require Congressional action. The Academy is working closely with other stakeholders to urge Congress to address these unsustainable cuts. Overall, CMS projects cuts to audiology of -2 percent for 2024. (If CMS issues any correction to the final rule, the Academy will update this information about the CF and the audiology payment table accordingly.)
- New Auditory Osseointegrated Device Service (AOD) codes: Two new codes for auditory osseointegrated device services will take effect in 2024. The new CPT codes are 92622 (Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes) and 92623 (Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure) for CY 2024. CPT code 92623 serves as the add-on code for base CPT code 92622. CMS has opted to finalize the AMA RUC valuations for these new services. The Academy will develop educational materials for members to assist with implementation for CY2024.
- Continued coverage of telemedicine: CMS finalized several telemedicine provisions, including allowing telehealth visits to originate at any site in the U.S. (e.g., individual’s home), payment for audio-only services, and permanently including Social Determinants of Health Risk Assessments. While many of the telehealth COVID-19 flexibilities are in place until the end of 2024, Congress and CMS are looking to establish permanent policies for 2025 and beyond.
Quality Payment Program (QPP) Provisions
CMS has added two new measures (317 and 498) to the audiology specialty measures set. These measures are voluntary for reporting. Audiologists subject to QPP reporting must report on 6 measures, and there are now 12 measures in the audiology specialty measures set.
Measure 317 – Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented: Percentage of patient visits for patients aged 18 years and older seen during the measurement period who were screened for high blood pressure AND a recommended follow-up plan is documented, as indicated, if blood pressure is elevated or hypertensive.
Measure 498 – Community Service Provider: Percent of patients 18 years or older who screen positive for one or more of the following health-related social needs (HRSNs): food insecurity, housing instability, transportation needs, utility help needs, or interpersonal safety; and had contact with a Community Service Provider (CSP) for at least one of their HRSNs within 60 days after screening.
CMS finalized plans to include audiologists in a new MVP―Quality Care for the Treatment of Ear, Nose, and Throat Disorders. The MVP is voluntary at this time and is aimed to focus on the clinical theme of providing care for patients experiencing some of the most common otolaryngology conditions such as, but not limited to, otologic conditions, chronic rhinosinusitis (CRS), age-related hearing loss (ARHL), and otitis media. CMS suggests this proposed MVP would be most applicable to clinicians who treat patients within the practice of otolaryngology, including NPPs such as audiologists, nurse practitioners, and physician assistants. The Academy will further review and analyze this provision.
The Academy will also further review this comprehensive rule for changes to Promoting Interoperability requirements as they apply to audiologists. The Audiology Quality Consortium submitted comments in response to the proposed rule in an attempt to gain clarity from CMS about the provisions; however, we are still in need of additional information. We will provide updates after further review and/or follow-up with CMS.
2024 Physician Fee Schedule Final Rule – 2023-24184.pdf (federalregister.gov)
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Audiology MPFS Final CY 2024 Table based on 11/2/2023 final rule release
The November 16, 2023, issue of MLN Matters provides the updated information to the Centers for Medicare and Medicaid Services (CMS) guidance “Allowing Audiologists to Provide Certain Diagnostic Tests Without a Physician Order.” The revised guidance now adds two new audiology codes to use with the AB modifier for direct access without a physician or non-physician…
The proposed rule for the Medicare Physician Fee Schedule (MPFS) for calendar year 2024 (CY24) shows another year of Medicare cuts for most providers, as reflected in the extensive red of the audiology code table included with a recent update from the Academy. The projected impact is a -2 percent cut overall for audiology codes…
UPDATE: July 19, 2023 On Thursday, July 13, the Centers for Medicare and Medicaid Services (CMS) posted proposed rules for both the 2024 Medicare Physician Fee Schedule (MPFS) and the 2024 Hospital Outpatient Prospective Payment System (OPPS). The Academy has analyzed both rules and provided payment tables with proposed payment rates for 2024. The text…