REVISED - Medicare Standardization Rates for Calendar Year 2024 (CY24)

Apr 08, 2024

The Centers for Medicare & Medicaid Services (CMS) has revised its rates effective March 9, 2024. To align with these changes, the Department is in the process of updating reimbursement rates for Medicare covered codes and services for the sections noted below. The new rates will reflect 72.4% of the most recent, 2024 Medicare rates.   

The Department has begun to post the updated fee schedules to the Rate Setting page of the Health PAS online portal and will continue to do so, as they are completed. Rates will be implemented over the course of the next two weeks, or shortly thereafter. No further noticing will be provided. 

Section 14	Advanced Practice Registered Nursing Services
Section 15	Chiropractic Services
Section 30	Family Planning Services
Section 68	Occupational Therapy Services
Section 75	Vision Services
Section 85	Physical Therapy Services
Section 90	Physician Services (*see exception below for Enhanced Primary Care Providers)
Section 95	Podiatry Services
Section 101	Medical Imaging Services
Section 109	Speech & Hearing Services

* Reimbursement for Enhanced Primary Care Provider services under Section 90, Physician Services will receive 100% of the current year Medicare rate. 

The Department is providing this notice pursuant to MRS Title 2021, §3173-J, which requires advance notice for planned Medicare fee schedule changes that do not require rulemaking.   

Note that these adjustments only apply to services benchmarked to Medicare under the specified Sections of Policy for eligible services above. When a Section of Policy cross-references rates in a separate Section of Policy, the reimbursement provisions in the cross-referenced section of policy dictates the reimbursement amount (e.g. reimbursement for laboratory services under Section 95, Podiatry, is dictated by reimbursement methodology and rates set forth in Section 55, Laboratory Services. Podiatry providers will continue to receive reimbursement for Laboratory services in accordance with Section 55).   

Adjustment of Claims  

• The Department will reprocess claims that were submitted at or above the new rates for dates of service from March 9, 2024, through the date of implementation and no provider action is required.  

• Providers who billed claims with charges below the new rates for the same date span above, will be responsible for adjusting claims as is deemed appropriate by the provider.    

For additional billing guidance, please see the How to Adjust Claims for Retro Rate Increases (PDF) document.  

Please contact your Provider Relations Specialist with questions.