Breaking Down the Impact of CMS's 2024 Medicare Physician Fee Schedule Final Rule

Nelson Mullins Riley & Scarborough LLP

The Centers for Medicare & Medicaid Services (CMS) has finalized the calendar year 2024 Medicare Physician Fee Schedule (PFS) final rule, introducing policies to bolster primary care, advance health equity, support family caregivers, and enhance access to behavioral and oral health care. The rule addresses various aspects, including payment reductions for clinicians, increased payments for primary and longitudinal care, and a new conversion factor.

Notably, the rule supports the current Administration's Cancer Moonshot initiative by providing payment for principal illness navigation services for cancer patients and enhancing behavioral health services. CMS is also promoting health equity by implementing coding and payment for caregiver training, community health integration services involving community health workers, and principal illness navigation services for individuals with high-risk conditions.

Additionally, the rule supports whole-person care by allowing enrollment of marriage and family therapists and mental health counselors in Medicare and increasing payments for crisis care, substance use disorder treatment, and psychotherapy. Dental services related to cancer treatments will now be reimbursed, aligning with the Cancer Moonshot initiative. The rule also extends Public Health Emergency Flexibilities for the Medicare Diabetes Prevention Program Expanded Model to improve care for individuals with diabetes.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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