2022 U.S. Proposed Payment Policies Released

On July 13, 2021, the Centers for Medicare and Medicaid Services (CMS) released the CY 2022 Medicare Physician Fee Schedule (MPFS) Rule. The rule will be posted in the Federal Register on July 23, 2021.

CY 2022 Medicare Physician Fee Schedule Proposed Rule

Conversion Factor & Impact to Echocardiography 

Overall, the proposed CY2022 MPFS conversion factor is $33.58, a decrease of $1.31 from the CY2021 PFS conversion factor of $34.89. The PFS conversion factor reflects the expiration of the 3.75 percent payment increase provided for CY2021 by the Consolidated Appropriations Act, 2021 (CAA). This Congressional intervention averted a significant cut in Medicare physician payment that would have decreased all services paid on the physician fee schedule. ASE will be working to secure congressional action to avert cuts to physician payments next year as physician practices across the country continue to recover from the pandemic.

New Add on CPT Code and Value for 3D

CMS proposes a valuation of 0.50 wRVUs for 3D Imaging of Cardiac Structures (CPT code 933X0). We thank everyone who received and completed a survey. It would have been impossible to defend these codes without accurate data from those who perform this service. ASE appreciates all the work of the physician advisors in shepherding these codes through the CPT Editorial Panel and RUC.

Appropriate Use Criteria (AUC) Program

CMS is proposing to begin the payment penalty phase of the AUC program on either January 1, 2023, or the January 1 that follows the declared end of the Public Health Emergency (PHE) for COVID-19. This flexible effective date is intended to take into account the impact that the PHE for COVID-19 has had, and may continue to have on practitioners, providers, and beneficiaries. Currently, the payment penalty phase of the AUC program is set to begin January 1, 2022. Note: this program is focused on advanced imaging services and does not include echocardiography services currently.

Read CMS’s summary of the MPFS proposed rule:

Read the Comparison of CY2021 Final – CY2022 Proposed MPFS Rates for Echocardiography.

ASE is beginning our analysis of the Proposed Rule and will provide a summary analysis and fee schedule impacts for members promptly.