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Medicare Fee Schedules and Workers’ Compensation in 2024 

20 Jun, 2024 NCCI

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WHAT: The Centers for Medicare and Medicaid Services (CMS) updates its reimbursement rules and rates for medical services each year.  

This report highlights the 2024 changes to CMS fee schedules for the following service categories: Physician, Facility, and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). 

KEY INSIGHTS: 

  • Effective January 1, 2024, CMS initially published the physician conversion factor of 32.7442, which was a 3.4% decrease from 2023.
    • Subsequently, Congress passed the Consolidated Appropriations Act, 2024, which included a temporary payment increase of 1.7%, effective March 9, 2024. 
    • This change increased the conversion factor to 33.2875, a 1.8% decrease from 2023, from March 9 through the end of 2024. 
  • CMS added a new code to the physician fee schedule in 2024.
    • This code, G2211, is an evaluation and management add-on code. We’ll monitor how commonly physicians utilize the code in WC. 
  • Facility base rates saw moderate increases in the 2% to 3% range. 
  • The 2.6% increase to the CMS DMEPOS update factor in 2024 is significantly lower than the increases seen in 2022 and 2023 of 5.1% and 8.7%, respectively. 

WHY IT MATTERS: Medical cost trends continue to be top of mind for industry stakeholders.  

The impacts of these changes on WC medical costs vary by state. The medical service categories covered by medical fee schedules, the extent to which each fee schedule incorporates the CMS rules and rates, and the distribution of medical costs all influence how each state is impacted. 

WHO: This report is authored by NCCI experts Jon Sinclair, FCAS, MAAA, Director & Actuary and Katherine Norris, Senior Actuarial Analyst. 

ACCESS THE FULL REPORT:  Medicare Fee Schedules and Workers Compensation in 2024  [link.mediaoutreach.meltwater.com]


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