Changes are coming to Medicare costs and coverage in 2024. On October 12, 2023, the Centers for Medicare & Medicaid Services (CMS) unveiled the premium, deductible, and coinsurance details for the Medicare Part A and Part B programs in 2024 and the 2024 Medicare Part D income-related monthly adjustment amounts. In addition, On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that announces finalized policy changes for Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues, effective on or after January 1, 2024.
Continue reading to discover the major shifts in Medicare for the upcoming year.
Medicare Part A &B
Starting January 1, 2024, the majority of individuals enrolled in Original Medicare (Part A and Part B) or a Medicare Advantage plan will be required to pay a standard monthly premium of $174.70 for Part B. This represents an uptick of $9.80 (equivalent to a 5.9% increase) compared to the rates in 2023. Concurrently, the annual deductible for Part B is also set to rise by $14 (or 6.2%) to reach $240.
Read more about Medicare Part B Income-Related Monthly Adjustment Amounts.
Behavioral health services in 2024
In 2024, Medicare is broadening the availability of behavioral health services. Notably, mental health counselors and marriage and family therapists can now enroll as Medicare providers for the first time. This initiative aims to enhance access to care for beneficiaries dealing with issues such as depression, anxiety, or substance use disorders by expanding the pool of professionals offering assistance.
Additionally, starting in January, Medicare is prolonging its coverage of intensive outpatient programs for mental health. As outlined in the Medicare and You 2024 Handbook by the Centers for Medicare and Medicaid Services, beneficiaries are responsible for 20% of the Medicare-approved amount and their Part B deductible for these services.
Telehealth services
Starting in CY 2024, telehealth services provided to individuals in their residences will be compensated at the non-facility PFS rate, ensuring continued access to mental health and other telehealth services.
Medicare covers telehealth services until Dec 31, 2024. However, following that date, most telehealth appointments will only be covered if conducted in a medical facility or office in a rural location. The exceptions to this rule are –
- Behavioral health services
- Treatment for a substance use disorder
- Diagnosis, evaluation, or treatment of a mental health disorder
- Monthly end-stage renal disease visits for home dialysis
Pain Management Services
Medicare-covered monthly services for pain management will cover the following:
- Pain assessment
- Medication management
- Care planning and coordination
Beneficiaries are required to cover their Part B deductible and coinsurance for these services.
See CMS guidelines for Telehealth Services Furnished in Teaching Settings
Physician fee schedule 2024
The final CY 2024 PFS conversion factor is $32.74, reflecting a decrease of $1.15 (equivalent to a 3.4% decline) from the current CY 2023 conversion factor of $33.89.
Vaccine administration at home
Effective January 1, 2024, Medicare Part B will pay providers the same additional payment amount to administer a pneumococcal, influenza, hepatitis B, or COVID-19 vaccine at home.
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