Medicare Payment and Regulations Resources

We understand the challenges of keeping current on how to appropriately bill and code for your Medicare patients. Below are a number of resources to help you ensure that you are paid appropriately and are not in violation of any Medicare policies.

2024 Medicare Physician Fee Schedule/QPP Final Rule

CMS published the 2024 Medicare Physician Fee Schedule (PFS) on November 2, 2023. The 2024 Medicare Physician Fee Schedule Final Rule includes implementation of code G2211 which better recognizes the resources necessary to provide patients with longitudinal, continuous care. ACP has spent years advocating for this type of code, which will allow clinicians to account for services like chronic disease management tracking, review of consultative or diagnostic reports, medication monitoring, safety outside of patient visits and physician input at assisted living or nursing homes. Educational resources to help internal medicine physicians understand how and when to use the G2211 add-on code will be available in early 2024.

However, because of Medicare program “budget neutrality” requirements the 2024 PFS also includes an across-the-board cut of nearly 3.4% to payment rates.

While the PFS is effective as of January 1, 2024, Congress can still stop these cuts. ACP is actively engaging in legislative advocacy through the end of January 2024 which would retroactively address the improper cuts to the fee schedule. All ACP members are encouraged to use ACP’s advocacy alert to ask your members of Congress to stop the cuts to physician payment.

Quality Payment Program (QPP)

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Quality Payment Program (QPP) to transition physicians away from a volume-based system toward one that rewards value.

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Telehealth Guidance and Resources

Offering guidance on clinical use cases, technology, regulations and waivers, and billing and coding.

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Getting Started with Medicare

 

How to Comply with Medicare Regulations

Advance Care Planning

Chronic Care Management

Transition Care Management Codes

Preventive Care Visits

Home Health Face-to-Face Encounter Requirement

Care Plan Oversight Encounter Worksheet and Instructions

Quality Payment Program

Medicare Improper Payment Review

Advanced Beneficiary Notices (ABN)