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The final Medicare Physician Fee Schedule (PFS) for 2023 released on November 2, 2022, by the Centers for Medicare & Medicaid Services (CMS) once again undermines the long-term financial viability of office-based specialists and seniors’ access to critical procedures, by generating significant cuts in physician reimbursement.

 

The cuts in the 2023 PFS Final Rule are on top of cuts of 20 – 40% for many specialty providers since 2006 and more recent cuts in the 2021 PFS Rule and the 2022 PFS Rule that are now being phased in over the next few years.  The 2021 PFS Rule cut the conversion factor by 10% due to the “EM policy” – a cut so large that Congress intervened to phase in the cut with the next 3% reduction occurring on January 1, 2023.  The 2022 PFS Rule cut the direct adjustment factor by 24% due to the “clinical labor policy” – with the result that the regulation cut some office-based specialists by more than 20% through 2025.  Now the 2023 PFS Final Rule is implementing another 1.5% cut, which, when combined with the previous policies will result in a total cut to certain office-based providers of up to 9% in 2023 alone.  

 

If not addressed, these painful cuts will force the closure of specialists providing services to cancer patients, dialysis patients, limb salvage patients, women seeking fibroid embolization, seniors seeking physical therapy and many others.  Many of these conditions disproportionately impact minority patients and the closure of these office-based specialty centers will exacerbate health equity, accelerate health system consolidation, reduce Medicare beneficiary access, increase Medicare program costs and beneficiary copays, and hasten the insolvency of the Medicare Part A Trust Fund.

 

Congress must take action now to stop further cuts to office-based specialists. 

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Watch our video:

"STOP The Ongoing Clinical Labor and EM Cuts"

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