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Medicare Physician Pay Cuts Underscore Need to Fix Broken System

By Kevin B. O'Reilly, AMA News Editor

What’s the news: U.S. physicians will face a 2% cut in Medicare payment in 2023, and 2024 will bring at least a 1.25% cut under the massive, must-pass omnibus spending deal struck by congressional leaders.

“The AMA is extremely disappointed and dismayed that Congress failed to prevent Medicare cuts next year, threatening the financial viability of physician practices and endangering access to care for Medicare beneficiaries,” said AMA President Jack Resneck Jr., MD. “This 2% cut, following two decades of flat payment rates, will have consequences on health care access for older Americans.”

Doctors had been staring down as much as 8.5% in 2023 Medicare pay cuts, but an advocacy campaign led by the AMA and joined by more than 150 organizations representing over 1 million physicians and other health care clinicians helped stave off many of the reductions.

Significantly, the budget deal includes a two-year postponement of the 4% in cuts from the pay-as-you-go sequester triggered by passage of the American Rescue Plan Act.

In addition, with this omnibus budget deal, Congress is poised to extend the Advanced Alternative Payment Model participation incentive at a reduced rate of 3.5%, and to delay for one year a scheduled increase in patient and revenue requirements to qualify for incentives.

Why it’s important: Washington politicians’ failure to stop the entirety of the Medicare pay cuts comes at a financially precarious time for physician practices left reeling in the COVID-19 pandemic’s third year.

“High inflation compounds the threat to practice viability because physicians are the only Medicare providers without annual inflation-based updates,” said Dr. Resneck, a dermatologist in the San Francisco Bay Area.

From 2001 to 2021, Medicare physician pay fell 22% (JPG) after adjusting for inflation in practice costs. Meanwhile, the Medicare physician payment system lacks an adequate annual physician payment update, unlike those that apply to other Medicare provider payments (PDF).  

“We are deeply worried that many practices will be forced to stop taking new Medicare patients—at a time when access to care is already inadequate,” Dr. Resneck said. “Congress must immediately begin the work of long-overdue Medicare physician payment reform that will lead to the program stability that beneficiaries and physicians need.”

CMS Annual Screening Services and New CLIA Waived Tests

By Jana Weis, Gill Compliance Solutions

As part of the 2023 Final Rule changes, two CMS screening codes for Annual Depression screening (G0444) and Annual Alcohol Misuse screening (G0442) are finally being revised after years of confusion with time requirements. Provider organizations have lobbied for CMS to revise the code descriptors to state “up to 15 minutes” instead of the current “15 minutes,” to clarify the time requirement when furnishing the service. As currently described, claims for the service are said to be denied by MACs in instances where records suggest that a full 15 minutes was not reached by the practitioner. Denials have also been issued for missing documentation of the screening tool used and clinician interpretation of the test. CMS has revised these codes to allow more flexibility with required time. For 2023, G0442 will read Annual alcohol misuse screening, 5 to 15 minutes” and G0444 Annual depression screening, 5 to 15 minutes. If under 5 minutes are spent performing these services, or if time is not documented, these codes should not be billed.

CMS added several new CLIA-waived tests with the effective date noted. Modifier -QW should be appended to these codes to denote the waived status. Please see the CMS Transmittal 11717 (https://www.cms.gov/files/document/r11717cp.pdf) for the complete list of approved codes and modifier requirements.

  • 82010QW, 82962, May 27, 2022, AmVentureX Inc. BioCoach Blood Glucose and Ketone Monitoring System;
  • 80305QW, June 07, 2022, Micro Distributing STATDIP One Step Drug Test;
  • 80305QW, June 07, 2022, Micro Distributing STATCup II One Step Drug Test Cup;
  • 87880QW, June 09, 2022, Clarity Diagnostics LLC Clarity Strep A Rapid Test Strip;
  • 87880QW, June 09, 2022, Independent Medical Co-op Inc. IMCO Strep A Rapid Test Strip;
  • 80305QW, August 31, 2022, Instant Technologies Inc. iSCREEN Urine Test Dx Drug Screen Square Cup;
  • 80305QW, August 31, 2022, Verséa Holdings Inc. Verséa THC One Step Marijuana Test Strip; and Pl
  • 86386QW, September 06, 2022, Abbott Diagnostics Scarborough Inc. NMP22 BladderChek Test (Prescription Home Use) and (Professional Use).

IMA Hosts 2023 Legislative Update Events Around the State

Over the last month, members of the Idaho Medical Association (IMA) and local representatives gathered throughout the state to discuss IMA's 2023 Legislative priorities. The IMA comprises seven Trustee Districts, 14 component medical societies, and over 3,700 members.

IMA's Legislative Update events are an excellent way of connecting local medical providers with their state legislators. These events are to educate and provide real-life examples of the issues facing medical providers and their impact on constituents' health. IMA team members traveled to Nampa, Boise, Twin Falls, Pocatello, Idaho Falls, and rounded out the 2023 Legislative Update events in Coeur d'Alene. Discussions ranged from the Idaho Patient Act, Expanding Graduate Medical Education, Ensuring Access to Women's Healthcare, to Physician Well-being & Impacts on Workforce.

"The legislative evening in the district is always a highlight of the year. It is an opportunity to meet new and established legislators, develop and grow relationships and discover information gaps that need to be filled. We are healthcare experts, and we need to lead with science. I informed one legislator that about 20 percent of pregnancies end by miscarriage, and they had no idea it was so frequent." ~Dr. Keith Davis, MD, Family Medicine) – Shoshone, ID

IMA looks forward to a productive and impactful year assisting Idaho physicians in having a voice at the Idaho Legislature and other policy-making forums.

For more information, please contact IMA Director of Government Affairs Mike Cunnington at cunnington@idmed.org

The IMA is looking forward to working with Dr. Swanson.


Congratulations District Four, Seat B Trustee, Dr. Elizabeth "Lisa" Swanson!

We are happy to announce that after careful review, the majority of the ballot votes were cast for candidate Dr. Elizabeth "Lisa" Swanson. Dr. Swanson will serve a four-year term as Trustee for District Four, Seat B.


Each trustee is a liaison between component societies and the IMA, represents the societies, advocates for and advises the societies, visits each society, and submits a report to the IMA House of Delegates regarding their trustee district.


It's Time To Renew Your IMA Membership!


Why Join IMA?

When you join the Idaho Medical Association, you hire a powerful staff to protect the viability of your practice. By protecting your practice from legal, legislative, and regulatory intrusions, your IMA membership lets you focus on what’s really important: Your Patients. Become a member today and join the IMA Community of over 3,500 Idaho physicians and medical professionals.


Visit www.idmed.org TODAY to easily join or renew for 2023!


Order Your 2023 ICD-10-CM Complete Official Code Set Today!

The newest codes in the ICD-10 book took effect as of October 1 and your billing staff will need to start using these new codes asap! The books are already at the IMA office and can be picked up, shipped, or delivered today! The 2023 ICD-10-CM files contain information on the ICD-10-CM updates for FY 2023.


As part of your membership, the Idaho Medical Association offers most coding, billing, and reference manuals at a significant discount. This saves you and your office money when you provide your staff with the tools to help you ward off unwelcome challenges to your revenue. The order form for 2023 publications is available here. If you have questions or if there is a type of book you don’t see but would like to purchase, please contact Rebecca Adams at rebecca@idmed.org or 208-344-7888.


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7th Annual SKIN: Practical Dermatology For the Generalist 2023 Conference

Don't forget about the upcoming 7th Annual SKIN: Practical Dermatology for the Generalist 2023 conference. The conference is occurring April 27-29, 2023 at The Camby in Phoenix, AZ.

Title: 7th Annual SKIN: Practical Dermatology for the Generalist 2023

Dates: April 27-29, 2023

Location: The Camby, Phoenix, AZ

URL: https://ce.mayo.edu/skin2023


  • LIVE
  • MD, DO, PhD: $675
  • NP, PA, Nurses, Retirees, Allied Health Professionals: $625
  • All Attendees: $675

Registration: https://ce.mayo.edu/dermatology/content/7th-annual-skin-practical-dermatology-generalist-2023#group-tabs-node-course-default1


Mayo Clinic’s 7th Annual SKIN: Practical Dermatology for the Generalists 2023, fills your CME needs. The course is taught by expert dermatologists from the three Mayo Clinic national practices in Minnesota, Florida, and Arizona. The course emphasizes general dermatology skills for the primary care physician and non-dermatologists in an interactive, case-based format with evidence-based lectures led by Mayo Clinic experts in dermatology. Topics discussed include management of moles, skin infections, cancers, rashes, lumps and bumps, and simple dermatologic procedures.

Available credit:

17.00 AAPA Category 1

17.00 AMA PRA Category 1 Credit™

17.00 ANCC

17.00 Attendance