New codes may enhance revenue opportunities for primary and palliative care.

CMS has released the final rule for the CY 2024 Medicare Physician Fee Schedule, which includes several innovations. First, CMS is finalizing its proposals for payment when: a) clinicians train caregivers to support patients with certain illness; b) when the clinician assesses unmet social needs that may be impacting treatment; c) when the clinical team works to address unmet social needs; and d) when patient navigation services to connect patients with high-risk conditions to clinical and social resources.

This latter payment is expected to be available to staff at community-based organizations, provided they are adequately supervised by the billing clinician. Second, CMS has authorized the use of a new add-on code, G2211, for additional payment for complex, whole-person care; appropriate evaluation and management codes may include this add-on code to increase total payment. Other changes include a 3.4% decrease in the conversion factor and modifications to the Medicare Shared Savings Program, which include risk-adjustments to encourage participation by ACOs caring for medically-complex, high-cost beneficiaries.

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