CMS’s Proposed 2025 Physician Fee schedule cuts all doctor reimbursement, even deeper cuts for office-based procedural care. Tell Congress to reverse the cuts and pass long term Part B payment reform!

CMS’s Proposed 2025 Physician Fee schedule cuts all doctor reimbursement, even deeper cuts for office-based procedural care. Tell Congress- reverse the cuts and pass long term Part B payment reform!

As we get closer to the November election, reimbursement cuts to doctors are again on the horizon for 2025, while almost all other parts of the US healthcare system see annual Federal updates. 

As part of the Centers for Medicare & Medicaid Services (CMS) mandatory rule-making process, the proposed 2025 CMS Physician Fee Schedule has been published for comments.  All comments are due no later than September 9th to the Agency.

The proposed Fee schedule is wide-ranging regulation that covers almost all aspects of the Part B program, including physician payment policies, quality payment provisions, coverage, and new services.  AVF members may read CMS’s public announcement here: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2025-medicare-physician-fee-schedule-proposed-rule

Key takeaways from the Proposed Rule for AVF members include:

  • Conversion Factor:  For 2025, CMS is proposing a Conversion Factor of $ 32.3562 compared to the current 2024 CF of $33.2875.  This is about a blanket -2.8% cut to all physician reimbursement rates.  As background, broadly, the CF x RVUs=physician payment.  In the office setting, Total Non-Facility RVUs are used to capture the costs of supplies and equipment
  • Since 2025 is the fourth and final year of CMS’s Clinical Labor Update policy, cuts to office based procedural care by specific CPT code are actually above and beyond the national -2.8% cut noted above. The table shows the office-based impact of the cuts on a selection of common venous codes used by AVF members.

On the Hospital Outpatient Prospective Payment side, CMS is proposing to update  OPPS payment rates for 2025 by 2.6 percent for hospitals that meet applicable quality reporting requirements 

“The cuts to all physicians caused by the reduced 2025 Conversion Factor underscores why Congress must act to remedy our broken national reimbursement system,” noted American Venous Forum President Dr. Ruth Bush.  “While we acknowledge the requirement of Budget Neutrality, year after year cuts to specialty care are driving consolidation right now and are already curtailing access to specialty care for our Medicare seniors,” added Dr. Bush.

“As we engage with our partners, I ask our AVF members to contact your lawmaker and share how CMS’s cuts have impacted your practice,” noted Dr. Gregory Snyder, Chair of the AVF’s Healthcare Policy Committee.  “Office-based specialists have seen dramatic cuts in recent years, and we know that many specialty providers are closing or deciding to retire, unable to keep their doors open,” added Dr. Snyder.

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As we get closer to the November election, reimbursement cuts to doctors are again on the horizon for 2025, while almost all other parts of the US healthcare system see annual Federal updates. 

As part of the Centers for Medicare & Medicaid Services (CMS) mandatory rule-making process, the proposed 2025 CMS Physician Fee Schedule has been published for comments.  All comments are due no later than September 9th to the Agency.

The proposed Fee schedule is wide-ranging regulation that covers almost all aspects of the Part B program, including physician payment policies, quality payment provisions, coverage, and new services.  AVF members may read CMS’s public announcement here: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2025-medicare-physician-fee-schedule-proposed-rule

Key takeaways from the Proposed Rule for AVF members include:

  • Conversion Factor:  For 2025, CMS is proposing a Conversion Factor of $ 32.3562 compared to the current 2024 CF of $33.2875.  This is about a blanket -2.8% cut to all physician reimbursement rates.  As background, broadly, the CF x RVUs=physician payment.  In the office setting, Total Non-Facility RVUs are used to capture the costs of supplies and equipment
  • Since 2025 is the fourth and final year of CMS’s Clinical Labor Update policy, cuts to office based procedural care by specific CPT code are actually above and beyond the national -2.8% cut noted above. The table shows the office-based impact of the cuts on a selection of common venous codes used by AVF members.

On the Hospital Outpatient Prospective Payment side, CMS is proposing to update  OPPS payment rates for 2025 by 2.6 percent for hospitals that meet applicable quality reporting requirements 

“The cuts to all physicians caused by the reduced 2025 Conversion Factor underscores why Congress must act to remedy our broken national reimbursement system,” noted American Venous Forum President Dr. Ruth Bush.  “While we acknowledge the requirement of Budget Neutrality, year after year cuts to specialty care are driving consolidation right now and are already curtailing access to specialty care for our Medicare seniors,” added Dr. Bush.

“As we engage with our partners, I ask our AVF members to contact your lawmaker and share how CMS’s cuts have impacted your practice,” noted Dr. Gregory Snyder, Chair of the AVF’s Healthcare Policy Committee.  “Office-based specialists have seen dramatic cuts in recent years, and we know that many specialty providers are closing or deciding to retire, unable to keep their doors open,” added Dr. Snyder.

AVF Members: Tell Congress to fix our broken doctor reimbursement system! Complete your information below to write a message that will be routed to your House member and Senators.