2022 Medicare Physician Fee Schedule Analysis

Yeo & Yeo Medical Billing & Consulting

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The 2022 calendar year physician fee schedule for Medicare physicians includes new proposals that may prove to be complex and intricate; these proposals can significantly impact group and individual practices starting as soon as January 1, 2022. The proposals will affect physician reimbursements, as well as quality reporting guidelines. Included in these are policy proposals that will update the annual conversion factor; “The conversion factor is the multiplier that Medicare applies to relative value units (RVUs) to calculate reimbursement for a particular service or procedure under Medicare’s fee-for-service system,” (Frieden, 2021 Medicare Fee Schedule). These proposals will also make changes to covered services that are rendered under telehealth, change the definition of what a shared visit looks like, and present the “Merit-based Incentive Payment System Value Pathways” as an option for reporting for the 2023 calendar year.

It is estimated that the conversion factor will decrease in amount from the previous year; $1.31 to be exact. Many physician organizations are working together to try and find a solution to these cuts before they are put into effect. Please see the charts below to see how this can affect your specialty.

Continuing on with payment for those telehealth services that were temporarily placed on the telehealth services list, CMS has granted an extension until the end of 2023. Normally, changes to telehealth billing guidelines are restricted to adhering to the list of covered telehealth services. However, due to the public health emergency (PHE) Covid-19, CMS has allowed flexibility. Changes to mental health services are being added to the list, allowing the patients’ home to be a place of rendering services as long as the patient has been seen in-person within the last 6 months. Following that, as long as the patient has been seen within the last 6 months, audio-only visits can be covered as well. The Covid-19 PHE has changed healthcare long-term by allowing more options for services to be rendered; as such, CMS has permanently approved covering the code G2252: brief communication via technology between the patient and physician or other qualified health care professional.

“A split/shared E/M [evaluation and management] visit is defined by Medicare Part B payment policy as a medically necessary encounter with a patient where the physician and a qualified NPP each personally perform a substantive portion of an E/M visit face-to-face with the same patient on the same date of service,” (AAPC, Medicare Policy). CMS intends to change this definition to reflect NPPs (non-physician practitioners) and their role in the health field. This proposal changes how these E/M visits can be billed by each health care professional, which visits can be billed, and which patients can be billed (established patients versus initial visits). Documentation has also been added to; the medical record must show both of the healthcare professionals that performed the visit, and the practitioner that performed a majority of the visit must sign and date the record.

CMS plans to increase the amount of specialties on the list of eligible clinicians for MIPS; this is including social work and certified nurse-midwives, and the performance category will automatically be reweighted to account for this change. This change not only affects those in social work and midwifery, but all group and individual practices; reweighting will impact those practices that have already been included on the MIPS list. Please click the links below to view the estimated impact on your specific specialty.

View the Medicare Specialty Description Amount Image 1

View the Medicare Specialty Description Amount Image 2


Aapc, Admin. “Medicare’s Split/Shared Visit Policy.” AAPC Knowledge Center, 1 Aug. 2008,,the%20same%20date%20of%20service.

Frieden, Joyce. “2021 Medicare Fee Schedule Includes 10.2% Cut in Conversion Factor.” Medical News, MedpageToday, 2 Dec. 2020,

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