In Depth Analysis

The CPT® Editorial Panel will meet in Albuquerque, New Mexico, from September 19 to 21, 2024. As published by the American Medical Association (AMA), the meeting agenda includes proposals to create new current procedural terminology (CPT) codes and to revise or delete existing codes. The AMA publishes a full agenda and a separate agenda specific to pathology/laboratory code requests, which include molecular pathology, multi-analyte assays with algorithmic analyses, and genomic sequencing procedure requests. Meeting attendees typically include physicians representing their medical specialty societies, representatives from industry, and public and private payors. The summary of panel actions (a document prepared after each meeting) for the September 2024 meeting will be posted on October 18, 2024, according to the AMA website.

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule [CMS-1809-P], which includes proposals to update payment rates and regulations affecting Medicare services furnished in hospital outpatient and ambulatory surgical center (ASC) settings beginning in CY 2025.

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B [CMS-1807-P] Proposed Rule, which includes proposals related to Medicare physician payment and the Quality Payment Program (QPP). Physicians and other clinicians are once again facing large proposed cuts of 2.8% for CY 2025. Ultimately, the rule outlines the limitations of the current fee schedule structure, and while Congress has provided temporary partial fixes to physician payment in the last several years, the relief expires at the end of 2024 unless legislation is passed.

The Centers for Medicare & Medicaid Services (CMS) recently hosted its second annual CMS Health Equity Conference on May 29 – 30, 2024, focusing on the theme “sustaining health equity through action.” The event was a significant gathering of more than 600 in-person attendees and more than 5,000 virtual participants, including leaders from federal agencies, healthcare providers, academia and community organizations.

On April 10, 2024, the Centers for Medicare & Medicaid Services (CMS) posted the Hospital Inpatient Prospective Payment System (IPPS) proposed update for fiscal year (FY) 2025, along with proposed policy and regulation changes. The proposed rule would update Medicare payment policies and quality reporting programs relevant for inpatient hospital services, and build on key agency priorities, including advancing health equity and improving the safety and quality of care.

Our new, interactive dashboard shows the actual costs to hospitals for providing care to Medicare fee-for-service inpatients based on data published by the Centers for Medicare & Medicaid Services (CMS) as part of its rulemaking cycle.