On July 13, the Centers for Medicare & Medicaid Services (CMS) released a 1,920-page proposed rule that would update payment policies and programs regarding Medicare payments to physicians and other providers under the Physician Fee Schedule (PFS) on or after January 1, 2024. Every year, industry stakeholders anticipate the release of this annual regulation because it updates the rules governing Medicare’s value-based programs and physician payment system. The proposed rule is open for public comment through September 11. Following the close of the public comment period, CMS will issue a final rule in late October or early November ahead of the January 1, 2024 implementation. While the lengthy rule includes numerous provisions, most notably it would: Unfortunately, the rule proposes a 2024 PFS conversion factor of $32.75, a decrease of 3.4 percent from the 2023 conversion factor of $33.89.This decrease reflects: the expiration of the 2.5 percent increase for 2023 included in a December 2022 law, the institution of a 1.25 percent increase for 2024 included in that same December 2022 law, and a 2.2 percent decrease resulting from Medicare’s statutory budget neutrality policies and the proposed addition of new codes and code values in 2024.As in the past several years, physician trade and advocacy associations are already lobbying Congress to reverse this cut.In response, some members of Congress have introduced legislation to permanently link these annual updates to a measure of inflation, but it’ll likely be difficult for Congress to gather the political support and find the spending “offsets” needed to pay for that legislation this year.