2023 CMS FINAL Payment Alert and Analysis Posted

Every year the Centers for Medicare and Medicaid Services (CMS) publishes two rules of interest to the ACMEGS; the Hospital Outpatient Prospective Payment System (HOPPS) and the Physician Fee Schedule (PFS). These rules determine the payment rates for the following year. In the case of MEG the HOPPS determines the payment to the hospital for the costs associated with the unit (also known as technical payment) and the PFS represents payment for the physician’s work in interpreting the data. Normally, a proposed rule is published in July that allows for public comments prior to the publication of the final rule in October.

CMS represents a very small number of annual MEG claims. In CY 2022 Meg spontaneous (95965) had 73 claims and Meg evoked (95966) had a total of 51 claims.

A complete analysis of codes relevant to ACMEGS members has been posted to the Clinical Resources section of the ACMEGS website.