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6 Key Items in CMS’ Proposed 2023 Physicians Fee Schedule

by | Jul 13, 2022 | News

Changes to PAMA reporting timelines and requirements, as well as payment cuts, are just some of the main takeaways labs should know about.

On July 7, the Centers for Medicare & Medicaid Services (CMS) published the 2023 Physician Fee Schedule (PFS) proposed rule. Key items affecting labs and lab owners:

  1. The PFS proposes to change PAMA reporting timelines and requirements in response to recent shuffling in price data reporting schedules;
  2. CMS wants to change the part of the PAMA regulations requiring phase-in of payment cuts to indicate that the payment for CY 2022 may not be reduced by more than 0 percent, as compared to CY 2020, and that 15 percent will be the maximum payment cut for CYs 2023 through 2025;
  3. CMS is proposing to “codify and clarify various laboratory specimen collection fee policies” included in the Medicare Claims Processing Publication;
  4. CMS wants to create new regulations governing the calculation of travel allowances for specimen collection;
  5. CMS is proposing to reduce the minimum age payment limitation for certain colorectal cancer screening to 45 years and add coverage of follow-on screening after a Medicare covered non-invasive stool-based colorectal cancer screening test returns a positive result; and
  6. By eliminating the COVID-19 pandemic payment bump of FY 2022, CMS is proposing a 3 percent cut in PFS payments for 2023.  

Look for a more detailed report on the 2023 Physicians Fee Schedule in the upcoming August 2022 issue of National Lab Reporter

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