2022 Medicare Conversion Factor “Final” – Quick Update

UPDATE 1/1/2022: The American Academy of Sleep Medicine (AAPM) is reporting the same $34.6062 CF I previously reported 12/27/2021. This is now confirmed via the complete PFS (Physician Fee Schedule) at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/PFS-Carrier-Specific-Files. So, the National Payment Amount (NPA) for the top ten services most frequently provided by psychologists in Medicare will be as follows this year:

HCPCS 2022 NPA
NON-FACILITY
2022 NPA
FACILITY
2021 NPA
NON-FACILITY
2022 RVU
NON-FACLITY
2021 RVU
NON-FACILITY
2022 RVU
FACILITY
90834 $102.78 $90.67 $103.28 2.97 2.96 2.62
90837 $150.88 $132.89 $152.48 4.36 4.37 3.84
90832 $77.86 $68.87 $77.81 2.25 2.23 1.99
90791 $178.91 $154.00 $180.75 5.17 5.18 4.45
96137 $40.49 $18.69 $41.87 1.17 1.2 0.54
96139 $35.99 $35.99 $37.34 1.04 1.07 1.04
96133 $102.78 $79.59 $103.98 2.97 2.98 2.30
96132 $132.54 $106.93 $133.29 3.83 3.82 3.09
90853 $27.34 $23.88 $27.57 0.79 0.79 0.69
90785 $14.88 $13.15 $15.00 0.43 0.43 0.38

Reimbursement will be at the “non-facility” (i.e., office) rate for telehealth until the PHE expires, at which time telehealth pricing will revert to the “non-facility rate” (cf. https://www.apaservices.org/practice/clinic/telehealth-coverage-access). In addition, barring additional congressional action, reimbursement will be reduced by the phased-in return of the “sequester,” by 1% beginning April 1, and by 2% beginning July 1.

Prior post as of 12/27/2021:

This “final” CF value means the Medicare National Payment Amount for 60 minutes of psychotherapy will be $150.88, decreased by 1% from the $152.48 NPA last year. That value of course will vary based on geographic adjustments.If so, this yields a change from the 2021 value ($34.8931) of -0.82%, in contrast to the originally proposed reduction of -3.71%. Yet to be seen in 2022 is the planned phase-in of the “sequester,” which will yield further reimbursement reductions of 1% beginning April 1, and 2% beginning July 1.Medicare’s “conversion factor” (CF) appears to have settled at $34.6062 for 2022. That’s based on drilling down to individual fees reported and apparently updated at NGSMedicare.com’s fee schedule lookup. I have not been able to confirm this via other sources, and have not seen this reported elsewhere.

Assuming no substantial changes in RVUs, a similar pattern will be seen for key psychological procedures.

An additional variable not factored in to this quick update is that Medicare reimbursement will revert to the the “facility” rate – substantially lower than the “non-facility” reimbursed since the beginning of the PHE – for psychological services provided via telehealth.

Here are estimates for how this looks in relation to inflation and past changes in the CF.

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