2024 Medicare Fee Schedule Updates: Reduction in Conversion Factor, Introduction to G2211 Add-On Code PDF Print Email
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Thursday, November 09, 2023 03:33 PM

2024 Medicare Fee Schedule Updates: Reduction in Conversion Factor, Introduction to G2211 Add-On Code

Late last week, the Centers for Medicare and Medicaid Services released their 2024 Medicare physician fee schedule and Quality Payment Program final rule. AAFP released this statement sharing initial reactions to the final rule. There are a few items to highlight, as AAFP continues to sort through the final rules.

The 2024 conversion factor is $32.7375 — about a 3.36% reduction compared to the 2023 conversion factor. The reduction is due to a statutory freeze on Medicare physician payment updates, budget neutrality adjustments, and the partial expiration of congressionally enacted conversion factor relief.

CMS finalized the G2211 add-on code for CY 2024, meaning family physicians can bill it alongside office/outpatient evaluation and management codes and receive a separate payment! This is an incremental but meaningful step toward investing more in primary care at the federal level.

  • CMS finalized a policy prohibiting clinicians from billing G2211 when they otherwise are billing a modifier 25. An exception for annual wellness visits will continue to be an advocacy priority.

  • Additional guidance on billing and documentation for G2211 from CMS may take several weeks to complete. 

The aggregate allowed charges to family medicine will increase by about 2% in 2024 from the finalization of G2211 and other policy changes. CMS estimates an additional increase in allowed charges for those in non-facility settings.

  • The specialty impact table in the proposed rule estimates that family medicine will experience a 3% increase in total allowed charges. Still, this number does not consider the expiring CF relief because it occurs outside of budget neutrality. 

CMS will maintain the MIPS performance threshold (the final MIPS score a participant must achieve to avoid a negative payment adjustment) at 75 for the 2024 performance year, a meaningful reduction from the proposed 82.

The Government Relations and Practice Advancement Teams are working on a more comprehensive summary of the final rule, which we hope to make available within the coming week. In the meantime, for members interested in adding their voice to advocacy efforts, we encourage you to send a SpeakOut to your Members of Congress urging them to allow the G2211 code to go into effect later this year.