Physician Fee Schedule Final Rule Invests in Primary Care, Despite Cut in Medicare Payments

Nov. 11, 2021 - Centers for Medicare and Medicaid Services (CMS) released its 2022 Medicare Physician Fee Schedule final rule on Nov. 2, which includes many positives for family physicians and patients that take effect Jan. 1, 2022, unless otherwise specified.

Among the changes is permanent coverage of tele-mental health services after the public health emergency is over. This is something MAFP has been advocating for at the state level, with the recent introduction of Senate Bill 707 , which has been referred to the Health Policy Committee.

Increased payment to physicians for administering vaccines is also included in the final rule; influenza, pneumococcal, and hepatitis B vaccines will be paid at $30 per dose—nearly double of the current rate of $17 per dose. Plus, throughout the year in which the COVID-19 public health emergency ends, CMS will continue to pay the current rate of $40 per COVID-19 vaccine dose.

Regarding e-presecribing, CMS is allowing prescribers to request a waiver when circumstances beyond the prescriber’s control prevent the prescriber from being able to electronically prescribe controlled substances covered by Medicare Part D. Also, CMS is delaying the start date for compliance actions to Jan. 1, 2023. This move may impact Michigan's e-prescribing mandate, which was postponed to Jan. 1, 2022, to align with CMS' previous compliance date. Stay tuned!

Another win for family physicians is that, for the first time in 20 years, CMS will increase clinical labor pricing over a four-year period. This investment in Medicare payments for clinical staff wages and benefits will reduce the financial burden of employing nurses, medical assistants, and other clinical staff.

While much of the final rule is very positive, a significant area of concern is a nearly 4% cut to fee-for-service Medicare payments. Unless Congress takes action, the conversion factor will be reduced from $34.89 to $33.59 in 2022. Please click here to contact your members of Congress to urge them to stop this cut that comes at a time when physician practices are still recovering from the COVID-19 pandemic fall-out and endangers patient access to care.

AAFP's comprehensive summary of the 2022 Medicare Physician Fee Schedule Final Rule

AAFP's response statement