Medicare Physician Fee Schedule Update

July 21, 2023

Late last week, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2024 proposed rules for the Medicare Physician Fee Schedule (MPFS), the Hospital Outpatient Prospective Payment (OPPS), and Ambulatory Surgical Center (ASC) Payment Systems

The agency proposed a CY 2024 conversion factor of $32.75, a decrease of approximately 3.4% from the CY 2023 Conversion Factor (CF). At a high level, LUGPA's specialty-based analysis of solely the MPFS suggests that this would translate to a roughly equivalent reduction in GU-specific codes. This CF cut occurs in a healthcare environment still struggling to recover from COVID-19 and against the backdrop of supply chain collapse, inflationary pressures, and workforce shortages. CMS proposed a modest 2.8% increase to OPPS payment, reflecting a market basket update of 3.0% reduced by a productivity adjustment of 0.2%. Each practice is encouraged to review its historical utilization of the MPFS to determine its impact on its practice in aggregate.

LUGPA has been stalwart in urging Congress to provide stable payment updates for physicians that reflect healthcare practice costs and was recently on Capitol Hill supporting HR2474, "Strengthening Medicare for Patients and Providers Act," along with other initiatives to allow independent providers to continue to compete with hospital systems. HR2474 would align MPFS increases with inflationary increases.  

Over the next several weeks and months, LUGPA health policy and political affairs staff are actively reviewing the two thousand thirty-three pages of proposed rules comprehensively and will provide additional summary information. LUGPA will also work with its lobbyists and other aligned stakeholders to develop and submit commentary to CMS for reconsideration and modification as the final rule is developed. 

Additional information on the rules can be found here:

PFS Press Release

PFS Fact Sheet

Medicare Shared Savings Program Fact Sheet

QPP Fact Sheet 

OPPS Press ReleaseOPPS Fact Sheet 


Announcing New Resources on 2024 Medicare Physician Fee Schedule Changes - Nov. 2023 - New! 

LUGPA Policy Brief: 2024 Medicare Physician Fee Schedule Payment Cuts - Nov. 2023