Effective date: January 1, 2024

Implementation date: January 2, 2024

CMS issued the 2024 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee-for-service (FFS) program. The 2024 deductible, coinsurance and base premium rates are:

Part A - Hospital insurance

Deductible: $1,632.00

Coinsurance

• $408.00 a day for days 61 through 90
• $816.00 a day for days 91 through 150 (lifetime reserve days)
• $204.00 a day for days 21 through 100 (skilled nursing facility coinsurance)

Part B - Supplementary medical insurance (SMI)

Under Part B of the Medicare supplementary medical insurance (SMI) program, enrollees are subject to a monthly premium. Most SMI services are subject to an annual deductible and coinsurance (percent of costs that the enrollee must pay), which are set by statute.

Standard premium: $174.70 a month

Deductible: $240.00 a year

Coinsurance: 20%

Reference: MM13365

Effective date: January 1, 2023

Implementation date: January 3, 2023

CMS issued the 2023 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee-for-service (FFS) program. The 2023 deductible, coinsurance and base premium rates are:

Part A - Hospital insurance

Deductible: $1,600.00

Coinsurance

• $400.00 a day for days 61 through 90
• $800.00 a day for days 91 through 150 (lifetime reserve days)
• $200.00 a day for days 21 through 100 (skilled nursing facility coinsurance)

Part B - Supplementary medical insurance (SMI)

Under Part B of the Medicare supplementary medical insurance (SMI) program, enrollees are subject to a monthly premium. Most SMI services are subject to an annual deductible and coinsurance (percent of costs that the enrollee must pay), which are set by statute.

Standard premium: $164.90 a month

Deductible: $226.00 a year

Coinsurance: 20%

Details are available in MLN Matters article MM12903  

KX modifier thresholds

Section 50202 of the Bipartisan Budget Act of 2018 repeals the application of the therapy caps while also retaining and adding limitations to ensure appropriate therapy. A provision of section 50202 of the BBA of 2018 adds section 1833(g)(7)(A) of the Act to preserve the former therapy cap amounts as thresholds above which claims must include the KX modifier to confirm that services are medically necessary as justified by appropriate documentation in the medical record.

These amounts are now known as the KX modifier thresholds:

PT and SLP services combined: $2,230

OT services: $2,230

Additional details available on CMS’ therapy services page

Effective date: January 1, 2022

Implementation date: January 3, 2022

CMS issued the 2022 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee-for-service (FFS) program. The 2022 deductible, coinsurance and base premium rates are:

Part A - Hospital insurance

Deductible: $1,556.00

Coinsurance

• $389.00 a day for days 61 through 90
• $778.00 a day for days 91 through 150 (lifetime reserve days)
• $194.50 a day for days 21 through 100 (skilled nursing facility coinsurance)

Part B - Supplementary medical insurance (SMI)

Under Part B of the Medicare supplementary medical insurance (SMI) program, enrollees are subject to a monthly premium. Most SMI services are subject to an annual deductible and coinsurance (percent of costs that the enrollee must pay), which are set by statute.

Standard premium: $170.10 a month

Deductible: $233.00 a year

Coinsurance: 20%

Details are available in MLN Matters article MM12507