The Centers for Medicare & Medicaid Services (CMS) has finalized policies in the calendar year 2024 Medicare Physician Fee Schedule (PFS) to enhance primary care, promote health equity, support family caregivers, and expand access to behavioral and certain oral health care. This includes payment for illness navigation services to aid patients and families in navigating cancer treatment and other serious illnesses, aligning with the Biden-Harris Administration’s Cancer Moonshot initiative.
CMS aims to strengthen Medicare by improving access to care for underserved communities, increasing support for family caregivers, and advancing behavioral health care. The PFS final rule updates payment amounts for clinicians, with an overall reduction of 1.25% compared to 2023. However, it increases payment for primary and longitudinal care. The rule also introduces payment for caregiver training, community health integration services, principal illness navigation services, and social determinants of health risk assessments.
In a significant move, CMS allows marriage and family therapists and mental health counselors to enroll in Medicare, expanding access to behavioral health care. The rule also supports whole-person care, encourages participation in the Medicare Shared Savings Program, and maintains performance thresholds for the Merit-Based Incentive Payment Systems (MIPS). See here for more details about the new enrollment eligibility for behavioral health providers.
Additionally, CMS finalizes payment for dental services related to cancer treatments and extends the Medicare Diabetes Prevention Program (MDPP) Expanded Model’s Public Health Emergency Flexibilities for four years, promoting care for individuals with diabetes.
See the full announcement here: https://www.cms.gov/newsroom/press-releases/cms-finalizes-physician-payment-rule-advances-health-equity
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