Medicare issues final 2025 physician fee schedule with 2.83% conversion factor cut
Medicare released the anticipated final 2025 fee schedule late Friday, incorporating a 2.83% cut to the conversion factor used to calculate physician payment.
The federal program will move forward with the reduction, which was originally proposed in July, resulting in a 2025 CF of $32.36. Imaging societies have lobbied lawmakers to undo the change over the last four months, but to no avail. Hope remains for action during the post-election lame duck session.
“Unless Congress acts soon, the Centers for Medicare and Medicaid Services’ cut…will make it challenging for interventional radiologists to deliver care to patients who need IR services in 2025 and beyond,” Society of Interventional Radiology President Robert J. Lewandowski, MD, said in a statement shared Nov. 1. “Despite rising practice costs, CMS continues to cut physician reimbursement, denying the reality of the burdens under which our healthcare system operates.”
SIR and others urged lawmakers to “act swiftly” in passing the Medicare Patient Access and Practice Stabilization Act (HR 10073). The bill would eliminate the 2.8% cut to the conversion factor and provide a modest inflationary update for 2025.
“Today's final rule throws the financial viability of physician practices into question and threatens beneficiary access to care,” Anders Gilberg, senior VP of government affairs for the Medical Group Management Association, which represents which represents over 15,000 group practices in radiology and other specialties, said in a statement. “On a positive note, we are pleased CMS heeded our call to finalize numerous telehealth policies, such as permanently covering audio-only services and extending flexibilities for direct supervision and home address reporting for practitioners. Congress must immediately return from recess to pass HR 10073, averting the 2025 cut to the conversion factor and stabilizing physician practices until a more permanent, sustainable solution to the Medicare physician payment system can be realized.”
SIR, MGMA and others will continue working with Congress to find a long-term fix for this annual conundrum. Budget requirements mandate that spending increases in Medicare necessitate cuts elsewhere in the fee schedule. Docs have pushed for the passage of the Strengthening Medicare for Patients and Providers Act (HR 2474), a separate bill that grants rads and other docs annual cost-of-living increases tied to the Medicare Economic Index (a measure of inflation).
“We think this is an equitable solution as physicians face increasing practice expenses and growing patient needs in the face of ongoing efforts to decrease reimbursements,” SIR’s Lewandowski said.
In other positive news, the American College of Radiology celebrated the finalization of plans for Medicare to cover CT-based screening for colon cancer. Radiologists have fought for this change for years and will finally see it enacted on Jan. 1.
“This decision will help improve access to CRC screening for underserved populations and people of color to help improve health disparities,” Judy Yee, MD, chair of the ACR Colon Cancer Committee, said in a statement. “Our goal is to continue to improve CRC screening rates across the country. Similar to colonoscopy, CTC can help prevent cancer by detecting the precursor polyp before it becomes cancerous.”
You can read more about the final rule in this Nov. 1 fact sheet from CMS. Radiology Business will update this story with further details.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.