Eight in 10 ENT physicians say a proposed CMS payment cut could reduce seniors’ access to care, with more than two-thirds saying they would need to see fewer Medicare patients and 14% saying they would stop accepting Medicare entirely, according to a survey from the American Academy of Otolaryngology–Head and Neck Surgery released Aug. 19.
The proposed 2027 Medicare Physician Fee Schedule would cut payment by 50% when a physician provides both a medical evaluation and a procedure during the same visit — a billing practice known as Modifier -25. CMS says the proposal is meant to address potential duplicate payments, but the AAO-HNS and nearly 20 other physician and patient organizations in the Same Day Care Coalition argue the existing payment system already accounts for overlapping work and that CMS has provided no evidence of a 50% overlap.
More than 84% of the 1,406 surveyed ENTs said the proposal could lead to longer wait times and fewer referral options, while 30% said they would need to lay off staff if the rule is finalized. The proposal is open for public comment through September 14 and would take effect January 1, 2027, if finalized.
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