New Proposed Rule for Physician Fee Schedule

August 2021

Last month, the Centers for Medicare & Medicaid Services (CMS) published the Medicare Physician Fee Schedule for Calendar Year 2022 Proposed Rule, or CY 2022 PFS Proposed Rule. This proposed rule continues a number of trends across the healthcare landscape, with public comments due by September 13. Key areas of the proposed rule include:

  • Telehealth: The CY 2022 PFS Proposed Rule, extends the approved reimbursement for telehealth services granted during earlier stages of the COVID-19 pandemic through 2023.
  • Medicare Shared Savings Program (MSSP): CMS proposes to allow MSSP Accountable Care Organizations (ACOs) to report quality measures via the CMS Web Interface for an additional two years. CMS is also proposing to freeze the threshold that ACOs need to meet to share in savings through 2023.
  • Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs): CMS introduced seven MVPs for implementation in the MIPS Performance Year 2023 in the areas of rheumatology, heart disease, stroke care and prevention, lower extremity joint repair, anesthesia, emergency medicine, and chronic disease management. MVPs allow physicians to report measures applicable to a designated specialty area.

Collectively, these changes present new opportunities to engage the value-based care landscape for stakeholders across the ecosystem, particularly in clinical areas addressed by one of the proposed MVPs.

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