Medicare Fees Increase… Slightly
President Biden signed a bipartisan spending package into law last Saturday (March 9, 2024), which includes a key provision adjusting the Medicare conversion factor. This change slightly mitigates the cuts to physician reimbursements, initially imposed on January 1, 2024, by reducing the 3.37% cut to 1.69%.
It is important for our members to understand that this adjustment is not retroactive and will only apply to services provided on or after March 9, 2024. Additionally, as of today, Medicare has not released the updated fee schedule. The ICS will notify members when the new schedule is released.
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Here is your best course of action for billing while waiting for CMS and NGS to post the new fee schedule:
PARTICIPATING PROVIDERS
If you are a participating provider for Medicare, we encourage you to continue to bill Medicare at your standard fees. Your bills will be processed based on the appropriate fee schedule once released.
NON-PARTICIPATING PROVIDERS
If you are NOT a participating provider for Medicare, we recommend that you wait to submit your bills until the correct schedule is released. However, based on our information, you may be able to process your claims using the currently published 2024 rates and inform your patients that additional amounts may be owed or require refunding.
The conservative approach for limiting charges is to hold your limiting charge amounts at the January 1, 2024 fee schedule levels until the new fee schedule is released.
Ongoing Medicare Fee Schedule Problem
This recent legislative update represents a small step forward in addressing the ongoing challenges faced in Medicare reimbursement. While the increase in the Medicare conversion factor offers some immediate relief, it serves as a temporary measure and highlights the continuing issue of cyclical pay cuts. There is a clear need for a more permanent and comprehensive reform in Medicare payment structures to ensure the sustainability of providing quality chiropractic care to Medicare beneficiaries.
It is also crucial to recognize that physicians, including chiropractors, remain the only group of healthcare providers not receiving automatic updates in their fee schedule to account for inflation. According to the American Medical Association, when adjusted for inflation in practice costs, Medicare physician pay has declined by approximately 30 percent since 2001. This trend underscores the urgency for long-term reforms to ensure that chiropractic services remain accessible and viable for all, especially our elderly patients who rely heavily on Medicare.
The Illinois Chiropractic Society will continue to work with other key organizations to advocate for the chiropractic profession and fight Congress’ continued reduction of Medicare fee schedules.
