ACE ALERT: Proposed 2022 Fee Schedule Released

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ACE Alert, July 20, 2021, Volume 30
Proposed 2022 Fee Schedule Released
This is the time of year that CMS releases its plans for the coming year and asks for comments.  While there are no great surprises, there are a few things we would like to point out:

2022 Proposed Fees
Reduction is the name of the game. The RVU calculation per-unit value is proposed at $33.5848, a reduction of $1.3083 from the current national fee of $34.8931. The anesthesia conversion rate is also proposed to be reduced from $21.5600 to $21.0442, a reduction of $0.5158.

There are a couple of hints regarding code values for 2022. They propose the unit value for 00537, anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation, go from the current CMS 7 base units assigned to 10 units.  Currently the ASA value is 10 and the RUC recommendation was to increase to 12 units. No hints from the ASA if they will be increasing the unit value.  CMS proposes deleting 01935 and 01936, anesthesia for percutaneous image-guided procedures on the spine and spinal cord, and replacing these codes with six new codes that will have more specificity to the descriptions. The six new codes will have base units of 4 and 5 assigned based on specificity. 

There was a large discussion on preventive services and the use of modifier 33. We have reviewed this closely and are not sure that these changes would affect anesthesia in any way as the current use of modifier 33 and PT do tell the payer that these are screening-related procedures. As reported last week, the NCD on screening colonoscopies does require the 33 modifier with the 00812 and the PT modifier with 00811 as of July 1st and the service started as a screening. We will watch this closely to see if there will be changes in 2022.

Finally, it looks like for 2023, we will have a new quality measure to report on, “Patient-reported experience with anesthesia.”  Get ready to deal with creating surveys in 2022 and working these surveys into your current work process.

The full preview of the fee schedule can be found here: https://www.federalregister.gov/public-inspection/2021-14973/medicare-program-cy-2022-payment-policies-under-the-physician-fee-schedule.

As always, we are here to help with your compliance, coding and auditing needs. Please give us a call or visit our website for more information.


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