Physician Fee Schedule
Physician Fee Schedule
Physician Fee Schedule: CY 2025 Proposed Rule – Submit Comments by September 9
CMS issued the CY 2025 Physician Fee Schedule (PFS) proposed rule to propose updates for Medicare PFS:
- Payment policies and rates
- Medicare Prescription Drug Inflation Rebate Program
- Behavioral Health Services
- Dental and Oral Health Services
- Opioid Treatment Programs
- Telehealth Services
- Rural Health Clinics and Federally Qualified Health Centers
See a summary of proposed provisions. Comments are due by September 9, 2024; see the proposed rule for details on how to submit them.
On March 9, 2024, President Biden signed the Consolidated Appropriations Act, 2024, which included a 2.93 percent update to the CY 2024 Physician Fee Schedule (PFS) Conversion Factor (CF) for dates of service March 9 through December 31, 2024. This replaces the 1.25 percent update provided by the Consolidated Appropriations Act, 2023, therefore the CY 2024 CF for dates of service January 1 through March 8, 2024 is $32.74. CMS has implemented the new legislation by adjusting the CY 2023 CF of $33.07 by 2.93 percent and the budget neutrality adjustment for a CY 2024 CF of $33.29 for dates of service March 9 through December 31. CMS is also releasing updated payment files, including the MPFS and associated abstract files, the Ambulatory Surgical Center (ASC) FS, and Anesthesia file.
Learn What's New for CY 2024
CMS issued the CY 2024 Physician Fee Schedule (PFS) final rule that announces policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues. See a summary of key provisions effective January 1, 2024.
Frequently asked questions (PDF) about services to help address health-related social needs in the 2024 Physician Fee Schedule final rule:
1. Caregiver training
2. Social determinants of health risk assessment
3. Community health integration
4. Principal illness navigation
The PFS is the primary method of payment for enrolled health care providers. Medicare uses the PFS when paying:
- Professional services of physicians and other health care providers in private practice
- Services covered incident to physicians’ services (other than certain drugs covered as incident to services)
- Diagnostic tests (other than clinical laboratory tests)
- Radiology services
Care Management
For a one-stop resource focused on new Care Management services under the Physician Fee Schedule, such as chronic care management and transitional care management services, visit the Care Management webpage.
Physician Center
For a one-stop resource focused on Medicare Fee-for-Service (FFS) physicians, visit the Physician Center webpage.
Downloads
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Request for Information- Reducing Scope of Practice Burden (PDF) -
Historical MPFSDB Layouts (PDF) -
Primary Care Incentive Program Payments for 2011 (PDF) -
Place of Service Codes for Professional Claims (PDF) -
Primary Care Incentive Program Payments for 2012 (PDF) -
FAQ on Billing G0453 for Remote Intraoperative Neurophysiology Monitoring (PDF) -
FAQs for CR 7502: Medicare’s 3-Day Payment Window and the Impacts on Wholly Owned or Wholly Operated Physician Practices (PDF) -
Development of A Validation Model for RVUs (PDF) -
FAQ for Mammography Services - Updated 1/18/17 (PDF)
Page Last Modified:
07/12/2024 11:49 AM