On July 13, the Centers for Medicare & Medicaid Services (CMS) released its proposed 2024 Medicare Physician Fee Schedule outlining cuts to pathologists, independent laboratories, and other specialties to offset increases to primary care physician services. The CAP has strongly opposed these cuts and is actively lobbying Congress to mitigate the decreases before they take effect.

Proposed Regulation Impact on Pathology Payment

Briefly, here are the key topics included in the 2024 proposed rule:

• The CMS proposed to implement evaluation and management add-on code, G2211, causing budget neutrality adjustments that negatively affect pathologists and other specialties throughout the physician fee schedule. Download the impact table showing the proposed changes to pathology services in 2024.
• The CMS increases Medicare Quality Payment Program (QPP) requirements for 2024.
• Learn more: Register for the CAP’s July 26 webinar providing a comprehensive overview of the proposed fee schedule changes to pathology services and the QPP.

In addition to the CAP, several physician associations said these continued cuts have negatively impacted physician practices in recent years and will have severe consequences in the long term. “These increasingly thin or negative operating margins disproportionately affect small, independent, and rural physician practices, as well as those treating low-income or other historically minoritized or marginalized patient communities,” American Medical Association President Jesse Ehrenfeld, MD, said in a statement. “Piling on more cuts is an unsustainable approach. Congress needs to turn its attention to fixing Medicare so we can preserve access for patients.”

The proposed regulation also included a request for information on histopathology, cytology, and clinical cytogenetics regulations under CLIA.

The request for information is soliciting feedback from the public on how to develop final regulations to achieve the following objectives:

• Developing regulations around slide staining and tissue processing as a part of the wider CLIA regulations and certification
• Making the public health emergency enforcement discretion permanent to allow pathologists to review slides remotely
• Making the public health emergency enforcement discretion permanent that allows for cytogeneticists to review images remotely

The CAP will analyze in detail the provisions of the proposed regulation and submit comments during the agency’s 60-day comment period which is through September 11.