Proposed Physician Fee Schedule for 2025 – Comment Period is Open!

On July 10, 2024, CMS announced the proposed 2025 Physician Fee Schedule. CMS is proposing a 2.93% average rate reduction. This basically removes the rate increase effective March 9, 2024, and a small adjustment to cover changes in the work relative value units (RVUs) for some services. This amounts to a proposed estimated CY 2025 PFS conversion factor of $32.36, a decrease of $0.93 (or 2.80%) from the current CY 2024 conversion factor of $33.29.

CMS is also proposing to update and expand coverage of colorectal cancer (CRC) screening. The coverage of barium enema as a method of screening will be removed (seldom used for Medicare patients). They are also proposing to expand coverage for CRC screening to include Computed Tomography (CT) Colonography. Finally, they are proposing to expand their approach to a “Complete CRC Screening” finalized in the CY 2023 PFS by adding that either a positive Medicare-covered blood-based biomarker test or non-invasive stool-based test is part of the CRC screening continuum and the follow-on colonoscopy would not incur beneficiary cost-sharing. The proposal should promote access and remove barriers for much-needed cancer prevention and early detection within rural communities and communities of color that are especially impacted.

Now is the time to let your voices be heard! Prepare and post your final rule comments by September 9, 2024. Contact your members of Congress to let them know how the rate reductions are impacting your practice.  See the full summary of the CMS 2025 Physician Fee Schedule Proposed Rule.