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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I write this brief message to bring a critical matter to your attention that is impacting our Medicare seniors.  I am a physician specializing in venous and lymphatic medicine, and it is my honor to care for our seniors and veterans.  But once again, CMS has published a proposed Physician Fee Schedule rule for 2025 that will push doctors like me to the financial breaking point.

Year after year, doctors are asked to endure cuts to CMS reimbursement, caused by the underlying statutory requirement of budget neutrality in the Physician Fee Schedule.  In the meantime, virtually all other parts of the healthcare system receive an annual update.  How is this sustainable?

Moreover, 2025 is the last year of CMS’s “Clinical Labor Update,”  CMS’s budget mechanism which seems straightforward at first glance, but actually this policy causes even more draconian cuts to office based specialty care like venous medicine, peripheral arterial disease care, and outpatient cancer and imaging care.   As doctors close their offices, or join larger health systems, these services are migrating to higher cost sites of service.  Why is Federal policy incentivizing this?

I respectfully ask for your review of the 2025 Proposed Fee Schedule rule, and for your support of H.R. 2474, the “Strengthening Medicare for Patients and Providers Act,” which would provide a permanent, annual update equal to the increase in the MEI and allow physician practices to invest in their practices and implement new strategies to provide high-value care.

Also, with recent bipartisan support from Rep. Gus Bilirakis of Florida and Rep. Tony Cárdenas of California, I urge you to support efforts to remedy the final year of the Clinical Labor Update, so that Medicare seniors can receive their needed care in the most cost-efficient and comfortable setting.
I am at the service of you and your staff to answer any questions, and I deeply thank you for your attention to these critical healthcare infrastructure issues.

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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.

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

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.