On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the 2025 Medicare Physician Fee Schedule (MPFS) Final Rule, set to take effect January 1, 2025. This new rule introduces a significant change to the Conversion Factor (CF), which directly impacts physician reimbursement rates.
What’s Changing in the 2025 Fee Schedule?
For 2025, the CF is set at $32.3465—a 2.83%, or 94 cent, reduction from the 2024 CF rate.
Additional Cuts in Sight: PAYGO and Sequestration
On top of this CF reduction, other looming cuts could amplify the impact on physician payments. These include:
- PAYGO (Pay-As-You-Go) Cuts: The American Rescue Plan wasn't fully funded, leading to a potential 4% PAYGO cut to Medicare reimbursements in 2025. Congress has previously delayed this cut in both 2022 and 2023, but it could return if not addressed.
- Sequestration Cuts: Originally delayed during COVID-19, the 2% sequestration cut was reactivated in April 2022. Efforts to postpone these cuts have so far been unsuccessful.
If Congress doesn’t intervene, these cuts combined could reduce physician reimbursement rates by a staggering 8.8% in 2025.
A Potential Solution: The Patient Access and Practice Stabilization Act of 2024 (HR 10073)
On October 29, 2024, the bipartisan Patient Access and Practice Stabilization Act of 2024 (HR 10073) was introduced in the House. If passed, this bill would reverse the 2.8% CF reduction and add a 1.8% increase to the CF, helping stabilize reimbursement rates for 2025.
Why Take Action?
Without intervention, these cuts could exacerbate the physician shortage, putting additional pressure on already strained healthcare providers.
Take Action Now! Urge Congress to pass the Patient Access and Practice Stabilization Act of 2024 (HR 10073) and protect the future of healthcare.
For more information on specialty-specific updates from the final rule, check out the CMS fact sheet for detailed insights.