2025 Medicare Physician Payment Schedule Released
The Centers for Medicare and Medicaid Services (CMS) has released its 2025 Medicare physician payment schedule, reflecting changes in the payment system, including mileage, modifiers for virtual care, and coverage for colorectal cancer (CRC) screening. The schedule was created with input from the American Medical Association (AMA) and aims to address longstanding concerns in the healthcare industry.
The updated payment schedule incorporates several key recommendations from the AMA. Notably, CMS has agreed to defer changes to the Medicare Economic Index (MEI) until the AMA's Physician Practice Information (PPI) Survey is analyzed, avoiding potential adverse effects on physicians' payments. Furthermore, audio-only visits will be included in the definition of telecommunications services, allowing for more flexible and accessible patient care. Additionally, the CMS has chosen to maintain the suspension of frequency limits on subsequent hospital and nursing facility telehealth visits, promoting continued digital healthcare options. The agency has also abolished the requirement for physicians to report their home address while delivering telehealth services.
While the updated payment schedule addresses some pressing issues, the AMA's president, Dr. Bruce Scott, emphasizes the ongoing need for Medicare reform. Dr. Scott remains concerned about the cumulative cuts to Medicare physician reimbursement since 2001, which have decreased by 29%. These cuts, primarily affecting rural patients, have hindered local care facilities, causing them to seek treatment from more distant healthcare providers. Consequently, expected cuts are projected to increase healthcare costs for patients, including a $3 monthly premium rise in Nebraska. Dr. Scott and Congressman Don Bacon urge lawmakers to reassess these reductions, arguing that any decline will harm older adults who rely heavily on this healthcare system.
In contrast, some have supported an exploration of potential improvements to the Medicare and Medicaid systems, such as reducing inefficiencies to cut costs. Oklahoma Representative Stephanie Bice has signaled her intention to develop alternatives like this, although her specific recommendations are yet to be publicly disclosed.
Given President-Elect Donald Trump's platform pledge to protect Medicare, his position may influence the minds of lawmakers who are considering cuts. Whatever the decision made as the debate around potential payments cut and improvements choose sides in an intensifying war, it is uniquely crucial to note that relief in long pandemic-amplified margins could help America stay on the right course set in affordable care as much as the millions of patients that record a flattened yield for unity being final tonight.
