ASA Urges Congress to Block New Payment Code and Cuts

On October 4, ASA joined 46 other organizations in urging Congress to block the implementation of G2211, a new Medicare payment code.  Absent Congressional intervention, the new code will take effect on January 1, 2024 and result in payment cuts to a full range of Medicare procedures, including anesthesia, pain and critical care procedures.

The implementation of G2211, which was previously delayed, was announced as part of the Medicare Physician Fee Schedule proposed rule, the draft regulation setting Medicare payment rates for 2024. CMS explained that the code, a special primary care service payment boost, is intended to reflect complexity related to evaluation and management (E/M) services for patients with serious or complex conditions.  The add-on may only be used in conjunction with office and outpatient E/M billing codes.  CMS intends to implement the code in a budget neutral manner, which means payments for other services will be cut to finance the payment boost for the E/M services.

CMS has calculated that as much as 90% of the over 3% CMS proposed 2024 cuts to both the anesthesia and resource-based related value scale (RBRVS) conversion factors are the result of the budget neutral implementation of the add-on code.