July 18, 2023

The 2024 Proposed Medicare Fee Schedule has been released, and it’s not looking good for anesthesia, chronic pain management and several other specialties. Last week, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that lists changes for Medicare payments under the Medicare Physician Fee Schedule (PFS), effective on or after January 1, 2024.

We will have further details arising from the proposed rule in upcoming alerts, but this special alert is focused on the proposed Medicare conversion factors (CFs)—the primary drivers that determine Medicare reimbursement rates. They are listed in the proposed rule as follows:

• The proposed 2024 RBRVS (non-anesthesia) conversion factor (CF) is listed as $32.74, which represents a decrease of $1.14 (or 3.36 percent) from the current 2023 CF of $33.88. This reflects a national average. The exact CF in your area may vary.
• The 2024 anesthesia CF is proposed as $20.43, down 3.26 percent from the current anesthesia CF of $21.12. Again, this reflects a national average. The actual CF may be a bit different in your geographic region.

So, once again, anesthesia and other providers face the prospect of yet another reduction in their reimbursement rates for an upcoming year. Yes, these reductions are not yet codified into law. Yes, the Congress is currently considering a bill that may put a permanent end to these annual announcements of gloom. But providers must still deal with the very real possibility that their Medicare cases will pay less next year, even while their Medicare case volume increases.

According to a CMS fact sheet summarizing the 2024 PFS proposed rule, “overall payment rates” under the PFS are slated to be reduced next year, but only by 1.25 percent. This would seem to be in conflict with the three-plus percent reduction in both CFs, as proposed. However, the more palatable 1.25 percent figure appears to be based on the proposed rule’s “significant increases in payment for primary care and other types of direct patient care.” Of course, this is hardly any consolation for those in the anesthesia community, given the fact that anesthesiologists and anesthetists are not considered primary care providers and thus will not be on the receiving end of these generous payment increases.

We will have more to say on this and other topics arising from the 2024 proposed rule in our upcoming weekly alerts. Be sure to keep an eye out for these important communications from Coronis Health.

With best wishes, 

Rita Astani
President—Anesthesia