The Ethical Healthpreneur

1.       Introduction The Medicare Physician Fee Schedule (PFS) serves as the bedrock for Medicare billing, covering services offered by physicians and a variety of other medical professionals since 1992. The PFS is versatile, applying to services rendered in multiple settings from physician offices to home care. It uses relative value units (RVUs) that encompass work, practice expense, and malpractice components, which, when combined with a conversion factor and geographic adjusters, determine the payment rates for services​ 1 ​. The 2024 updates are particularly pivotal. They include a 1.25% decrease in overall payment rates from the previous year, with the conversion factor reducing to $32.74. However, these updates also bring significant payment increases for primary care and direct patient care, reflecting a move towards more equitable healthcare with improved access and quality​ 1 ​. Newly finalized policies for 2024 reflect a commitment to addressing broader health-related socia

    On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) issued the final rule for the calendar year (CY) 2024 Medicare Physician Fee Schedule (PFS), which determines the payment rates for physician services under Medicare Part B. The final rule includes a 1.25% overall reduction for physician services in 2024, as well as several policy changes that affect the quality reporting, value-based payment, and beneficiary assignment for physicians and other billing professionals.   What is the Medicare Physician Fee Schedule?   The Medicare Physician Fee Schedule (PFS) is a system of payment for the services of physicians and other billing professionals who provide care to Medicare beneficiaries. The PFS covers a wide range of settings, such as physician offices, hospitals, ambulatory surgical centers, skilled nursing facilities, hospices, outpatient dialysis facilities, clinical laboratories, and beneficiaries’ homes.   The PFS payment rates are based on the relative r