Here are six things to know:
1. CMS finalized a 2.83% physician pay cut. The physician fee schedule conversion factor for 2025 is $32.35, down from $33.29 in 2024.
2. CMS also finalized a reimbursement increase of 2.9% for ASCs meeting quality reporting requirements next year. Updated reimbursement increases are based on a projected hospital market basket percentage increase of 3.4%, and then a 0.5 percentage point productivity adjustment. The final rule is 0.3% up from the proposed rule.
3. After the rule was proposed in July, Manoj Mehta, MD, gastroenterologist at the Chicago-based Endoscopy Center of the North Shore, told Becker’s that “Medicare’s annual reduction in reimbursement for physician services is a key driver of patient dissatisfaction with the healthcare system.”
“By reducing payments for individual services, Medicare drives physicians to perform volume-based practices,” he added. “Any conscientious physician who strives to do this will soon be out of business in the current model, unless they adopt even more isolating models like concierge medicine. If you are a patient who is frustrated by doctors treating you like a number, or charging extra fees, look no further than the Medicare reimbursement model to blame.”
4. CMS did not add any surgical procedures to the ASC covered list for next year. The agency did add 19 dental codes and two adipose-derived regenerative cell therapy codes.
5. CMS also updated the ASC quality reporting program for 2025.
- The Facility Commitment to Health Equity measure assesses a facility’s commitment to health equity.
- The Screening for Social Drivers of Health measure starts with a voluntary reporting period in 2025 with mandatory reporting beginning in 2026.
- The Screen Positive Rate for Social Drivers of Health measure begins with voluntary reporting in 2025 with mandatory reporting beginning in 2026.
6. CMS also began requiring hospitals to report specific admission information. The new rule governs reporting admission information related to respiratory illnesses, including capacity, to the CDC, and reinstates some pandemic-era requirements that have been voluntary since May 1.
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