CY 2023 Physician Fee Schedule Final Rule Summary Part III – Quality Payment Program Updates

On November 2, 2022, CMS placed on public display a final rule relating to the Medicare physician fee schedule (PFS) for CY 2023 and other revisions to Medicare Part B policies. The final rule is scheduled to be published in the November 18, 2022, issue of the Federal Register. HFMA is providing a PFS summary in three parts. Part III covers the updates to the Quality Payment Program. Previously covered in Part I were sections I through III.N of the rule (except for section III.G., Medicare Shared Savings Program Requirements) and section VII, Regulatory Impact Analysis. Previously covered in Part II were the Medicare Shared Savings Program Requirements. Part III presents finalized policies related to the Quality Payment Program, including Traditional Merit-based Incentive Payment System (MIPS), MIPS Value Pathways, and the Alternative Payment Model (APM) Incentive. Changes include updates to the MIPS Quality and Improvement Activities inventories, addition of five new MIPS Value Pathways, revising the criteria for making Advanced APM determinations, and setting the MIPS final score performance threshold at 75 points for performance year 2023/payment year 2025 (no change from prior year). Changes will take effect on January 1, 2023, unless otherwise noted.