On March 8th, 2024, Congress passed a partial government funding bill that includes a 1.68% reduction to the 3.37% cut in the 2024 CMS Physician Fee Schedule conversion factor.1 The updated reduction went into effect on March 9th, 2024 and therefore will not impact payments with the original 3.37% cut from January 1st-March 8th 2024. This new payment will apply prospectively for the remainder of 2024 and represents one of several partial fixes from Congress to the PFS conversion factor (CF) over the last few years.
For context, Congress approved “funding patch” legislation through the Consolidated Appropriations Act of 2023 that provided a 2.5% increase for CY 2023, yet there was only a 1.25% increase for CY 2024. Combined with a statutory 0% update and a negative 2.18% budget neutrality adjustment for the PFS in 2024, the overall CF was set at 3.37% starting January 1st, 2024. As mentioned, Congress has stepped in to provide relief for physicians, but this marks the first partial fix that does not encompass the entire year.
See below for updated CPT code rates for CCM and PCM.
| CPT Code | Original 2024 Rate* (January 1st-March 8th) | Updated 2024 Rate* (March 9th-December 31st) |
|---|---|---|
| CPT 99490 | $61.56 | $62.58 |
| CPT 99439 | $47.15 | $47.93 |
| CPT 99487 | $131.96 | $134.15 |
| CPT 99489 | $71.05 | $72.23 |
*Rates based on the CMS 2024 Physician Fee Schedule — National Average2
Due to budget neutrality constraints, CMS must consider reimbursement changes to all CPT and HCPCS codes in order to stay within a $20M threshold. While this partial funding bill is a positive step in the right direction, we hope that the CMS conversion factor will have smaller overall adjustments in the PFS for years to come. See below for a note from CMS on the updated conversion factor.
A note released from CMS: “The CY 2024 Medicare Physician Fee Schedule has been updated by the annual PFS Final Rule for various new policies and for new and existing CPT/HCPCS codes. For January 1, 2024, through March 8, 2024, the PFS conversion factor is $32.7442. For March 9, 2024, through December 31, 2024, the CY 2024 Medicare Physician Fee Schedule has been updated by new legislation that revises the PFS conversion factor to $33.2875.”
