CY 2022 Physician Fee Schedule Final Rule

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

Late afternoon of November 2, 2021 (filed at 4:15pm ET), CMS announced“actions that will advance its strategic commitment to drive innovation to support health equity and high quality, person-centered care. CMS’ Calendar Year (CY) 2022 Physician Fee Schedule (PFS) final rule will promote greater use of telehealth and other telecommunications technologies for providing behavioral health care services, encourage growth in the diabetes prevention program, and boost payment rates for vaccine administration. The final rule also advances programs to improve the quality of care for people with Medicare by incentivizing clinicians to deliver improved outcomes.”  The 2414-page Final Rule is effective January 1, 2022.  (This is the public document; this document is scheduled to be published in the Federal Register on 11/19/2021 and available online at, and on  This is a major rule that addresses:

  • changes to the physician fee schedule (PFS)
  • changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute
  • Medicare Shared Savings Program requirements
  • updates to the Quality Payment Program
  • Medicare coverage of opioid use disorder services furnished by opioid treatment programs
  • updates to certain Medicare provider enrollment policies
  • requirements for prepayment and post payment medical review activities
  • requirement for electronic prescribing for controlled substances for a covered Part D drug under a prescription drug plan, or a Medicare Advantage Prescription Drug (MA-PD) plan
  • updates to the Medicare Ground Ambulance Data Collection System
  • changes to the Medicare Diabetes Prevention Program (MDPP) expanded model
  • amendments to the physician self-referral law regulations

Additional information resources include:

Fact Sheet on the CY 2022 Physician Fee Schedule Final Rule

Fact Sheet on Final Changes to the CY 2022 Quality Payment Program

Fact Sheet on Final Changes to the Medicare Diabetes Prevention ProgramCY 2022 Physician Fee Schedule