The 2024 Medicare Physician Fee Schedule (MPFS) Final Rule introduces extensive changes, including substantial cuts to the 2024 conversion factor, updates to the Medicare Economic Index, and significant alterations to Evaluation and Management (E/M) services. The revisions extend to code valuations and various quality reporting programs. Faced with record-breaking inflation, physician and provider organizations are expressing outrage and advocating for urgent congressional action and payment reform. In response, a webinar has been organized to thoroughly dissect these updates, offering healthcare professionals actionable insights to navigate the complexities effectively. The session aims to empower participants with tangible information that can be immediately applied in response to the unprecedented changes in the healthcare landscape. Register, https://conferencepanel.com/conference/navigating-the-2024-medicare-physician-fee-schedule-mpfs-final-rule-updates

1. Navigating the 2024 MPFS
Final Rule Updates
PRESENTED BY:
TONI ELHOMS, CCS, CPC, CPMA, CRC, AHIMA-
APPROVED ICD-10-CM / PCS TRAINER
1

2. Toni Elhoms, CCS, CPC, CPMA, CRC,
AHIMA Approved ICD-10-CM/PCS Trainer
❑ CEO – Alpha Coding Experts
❑ Podcast Host – Alpha Coding Podcast
❑ National Speaker - Coding, Compliance,
and Reimbursement SME
❑ Former President of Orlando, Florida
AAPC Chapter
❑ Expert Witness
❑ Published Author
❑ Consultant/Educator/Trainer
2

3. Agenda
Review the key 2024 MPFS Updates
Discuss the financial impacts of 2024 MPFS Final Rule (Conversion Factor and MEI)
Discuss the impacts of the 2024 Evaluation and Management Updates
Review the major changes to Remote Care Services
Q&A at the end
3

4. 2024 MPFS Updates
❑ 2024 Final Rule MPFS Conversion Factor (CF) was set at
$32.7442
❑ Represented a $1.15/3.37% payment reduction
❑ 2023 CF was $33.8872
❑ 2024 Anesthesia CF = $20.4349
❑ Represented a $.69 payment reduction
❑ 2023 CF was $21.1249
❑ With record-breaking inflation, many industry
stakeholders were outraged and called for
Congressional action STAT
❑ Appropriate Use Criteria Program (AUC) is gone!
❑ Due to AMA advocacy, CMS maintained the performance threshold to
avoid a penalty in MIPS at 75 points in 2024
❑ Delayed mandatory eCQM adoption by MSSPs in 2024
❑ New tool created for ACOs-only called Medicare CQMs
4

5. 2024 MPFS Updates
❑ 78% of E-clinicians will avoid a MIPS penalty in 2026, a
significant improvement from the CMS projection that
50% of eligible clinicians would avoid a penalty in the
proposed rule
❑ CMS will allow CSWs, LMFTs, and MHCs to provide
health behavior assessment and intervention services
through CMS
❑ CMS will allow LPCs, Addiction Counselors, and LMFTs
to enroll in Medicare and bill as mental health
professionals – greatly expanding access to BH
Providers
❑ 400,000 LMFT and MHCs professionals are now able to
get paid and render services to Medicare Beneficiaries
5

6. 2024 MPFS Updates
❑ Medicare Approved List of Telehealth Services will
continue to be covered through the end of 2024
❑ Waived geographic and originating site restrictions
❑ Medicare Approved List of Telehealth Services will
continue to be reimbursed at non-facility
reimbursement rates
❑ Medicare is extending payment for codes
approved for audio-only Telephone visits based on
the Medicare Approved List of Telehealth Services
❑ Medicare will continue to allow direct supervision to
be provided virtually for the Approved List of
Telehealth Services
6

7. 2024 MPFS Updates
❑ Split/Shared Visits – CMS revised its definition of
“substantive portion” of a visit to reflect the
revisions CPT E/M guidelines state
❑ Substantive portion = more than 50% of the total
time spent by the physician/QHP performing the
split/shared visit OR a substantive part of the
MDM as defined by CPT
❑ Finally, some alignment between CMS and CPT
❑ Delayed CMS time-only policy for 3rd year in a
row
7

8. Remote Patient Monitoring
(RPM)
Source: Optum360 + AMA
8

9. Remote Therapeutic
Monitoring (RTM)
Source: Optum360 + AMA
9

10. Oversight
Audits:
❑ Internal
❑ External
Frequency:
❑ Monthly
❑ Quarterly
Image: thatchertech.com
10

11. Resources
❑ American Medical Association (AMA)
❑ Centers for Medicare and Medicaid Services
(CMS)
❑ Code of Federal Regulations (CFR)
❑ CodingIntel.com
❑ Federal Register
❑ Foley & Lardner LLP
❑ Optum360
11

12. 12

13. Register Now
13