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CMS updates Conversion Factor

January 10, 2023

The Centers for Medicare and Medicaid Services (CMS) recently released updated Medicare physician payment files reflecting an $0.83 change to the conversion factor made under the Consolidated Appropriations Act of 2023 (CAA), which was passed by Congress late last month.

Why it matters: Medicare reimbursement is calculated by multiplying the number of relative value units for a procedure by the Medicare Physician Fee Schedule (MPFS) conversion factor. Under the 2023 MPFS Final Rule, CMS set the conversion factor at $33.0607, a cut to the 2022 conversion factor of $34.6062. With the CAA, Congress reduced this cut by increasing the 2023 conversion factor by 2.5%, to $33.8872.

It is disappointing that Congress did not include full physician payment relief in the CAA, as only providing partial payment relief from conversion factor cuts is insufficient. ASTRO will work with the new Congress to address outstanding priorities, including Medicare reimbursement reform for radiation therapy and prior authorization.

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