Final 2024 Medicare Physician Payment Rule Negatively Impacts Anesthesia Groups, Harms Patient Access to Surgical Care

CHICAGO – The American Society of Anesthesiologists (ASA) calls on Congress to block a 3.27% Medicare payment cut to anesthesiologists and other physicians included in the Centers for Medicare & Medicaid Services (CMS) 2024 Medicare Physician Fee Schedule (PFS) final rule released today. These significant cuts will compound the financial strain anesthesia groups are already facing and harm seniors’ access to surgical care. Without congressional action, the new cuts will be effective January 1, 2024.

“Once again, Medicare payments to physician practices will be drastically cut, with anesthesiologists, critical care and pain medicine physicians being disproportionately impacted,” said ASA President Ronald L. Harter, M.D., FASA. “Congress must act before the end of the year to prevent these deleterious cuts from negatively impacting the Medicare patient population’s access to care.  A critical, immediate fix that Congress can do is to block the new G2211 payment code that CMS will launch in its 2024 PFS, which creates instability and imbalance in the payment system. This can be done efficiently by Congress with no impact to the Medicare budget.  Congress could also pass hold harmless legislation to protect other important Medicare services from the G2211 generated cuts.”

Within the fee schedule, CMS has finalized significant Medicare payment cuts to the Anesthesia Conversion Factor (CF), the Resource-Based Relative Value Scale (RBRVS), and the bundling of certain procedure codes that will result in anesthesiologists, critical care and pain medicine physicians receiving less payment in 2024. The 2024 finalized CF is $20.4349, representing a decrease of 3.27% from the 2023 CF of $21.1249. The 2024 finalized RBRVS is $32.7442, representing a decrease of 3.37% from the 2023 RBRVS of $33.8872.

Nearly 90% of the negative budget neutrality adjustment to the CF that anesthesiologists and other physicians will face in 2024 is attributable to a new bonus payment for office and outpatient “evaluation and management” (E/M) code, or G2211, that CMS has finalized for use in the 2024 payment year. Despite CMS making some revised utilization assumptions, implementing G2211 will significantly reduce anesthesiologist payments in 2024.

“ASA vehemently opposed the implementation of this code because it is duplicative of the work already accounted for by existing codes and will inappropriately result in overpayments for some physicians, paid for by underpayments for other important services, including anesthesia care,” said Dr. Harter.

ASA is committed to advocating for changes to the broken Medicare payment system and to ensure anesthesiologists, critical care and pain medicine physicians are paid fairly for the services they provide to their patients. ASA has supported an inflation adjustment to Medicare payments to allow for the compensation of physicians and other clinicians to match the rising cost of living across the country. Legislation — H.R. 2474, the Strengthening Medicare for Patients and Providers Act — has been introduced in Congress to achieve this change. ASA has also supported Congress and policymakers in re-evaluating the budget neutrality clauses of the Medicare PFS that greatly restrict payment and cause continued decreases in the CF. 

“Congress must advance bipartisan legislation and policy aimed at mitigating future Medicare payment cuts,” said Dr. Harter. “Improvements that are based on reality and create stability and relief within our Medicare physician payment system are needed to ensure timely access and high-quality care for patients.”

Please see ASA’s Washington Alert for more details on how the proposed rule will affect anesthesia and other pain management services.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 57,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about how anesthesiologists help ensure patient safety, visit asahq.org/MadeforThisMoment. Like ASA on Facebook and follow ASALifeline on Twitter.

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