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Internal Medicine Physicians Encouraged by Proposals in 2023 Medicare Rules

WASHINGTON July 8, 2022 – Many of the provisions of the proposed Medicare Physician Fee Schedule for 2023 will help to better recognize the value that internal medicine physicians provide to their patients says the American College of Physicians (ACP). The proposed 2023 Medicare Physician Fee Schedule and Medicare Shared Savings Program rules were released by the Centers for Medicare and Medicaid Services (CMS) Thursday afternoon.

“We are particularly glad to see that CMS included the increased value for evaluation and management (E/M) codes used in inpatient settings in the fee schedule,” said Ryan D. Mire, MD, FACP, president, ACP. “The changes in these codes, combined with the changes made to outpatient E/M codes in 2021, are significant in recognizing the value that internal medicine physicians contribute to their patients and our health care system across a variety of health care settings.”

In addition to changes in value for E/M codes, the proposed fee schedule includes a delay in the implementation for changes to the way that physicians bill for E/M services that are provided jointly with a qualified health care professional. ACP is relieved that this recommendation is in line with concerns previously expressed to CMS and will allow for additional time to better understand the potential impact these changes would have on physicians and other health care professionals. 

The fee schedule also moves forward with implementing a longer extension for many of the telehealth services that have been allowed during the public health emergency (PHE) caused by the COVID-19 pandemic, an extension that ACP has previously advocated for in order to provide additional time to assess the benefit of these services for patient care.

“The increased use of telehealth services has been vital to providing care to my patients during the COVID-19 pandemic, but it can also serve as a tool to better meet the needs of patients in non-emergency times,” continued Dr. Mire. “Allowing the expanded role for telehealth to continue has the potential to enhance patient-physician collaboration and increase access to care. We believe that telehealth should continue to be an important component of health care delivery.”

The proposed Medicare Shared Saving Program rule looks promising in its inclusion of changes to address social drivers of health and improve health equity. The rule also includes new MIPS Value Pathways (MVPs) for 2023. Among the MVPs included for next year is the Promoting Wellness Pathway. This pathway is similar to a pathway on Preventive Care that ACP had previously suggested to CMS when they were seeking feedback on the creation of MVPs.

However, while there are promising areas in the proposed rule, ACP remains very concerned about the significant cut to physician payments that are proposed for Jan. 1, which offset the increased valuation to the E/M codes proposed.

“We need to find a solution that will prevent the cuts that are scheduled for next year, but it is also imperative that we find a long-term solution that addresses the structural problems in Medicare that cause repeated issues with payments under the fee schedule,” concluded Dr. Mire. “ACP will continue to advocate with Congress and the administration on both short and long-term solutions. We will be further analyzing the details and impact of proposed rule for next year and sharing our feedback with CMS.”

Contact: Jacquelyn Blaser, (202) 261-4572, jblaser@acponline.org

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About the American College of Physicians

The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 160,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter, Facebook, and Instagram.