CMS Proposes More Medicare Cuts for Surgeons

On July 10, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2025 Medicare Physician Fee Schedule (MPFS) proposed rule. This rule, which CMS issues annually, updates payment policies and quality provisions for services furnished under the MPFS on or after January 1, 2025.

The Agency proposed a CY 2025 conversion factor of $32.36, which is a decrease of nearly 3% from the CY 2024 conversion factor—as such, absent Congressional intervention, general surgery will face a 2.8% cut in Medicare Part B payments. CMS also introduced new proposed coding and billing requirements for global surgical packages and expanded coverage for certain colorectal cancer screening tests.

The MPFS proposed rule also provides annual updates to the 2025 Quality Payment Program (QPP) Performance Year, which encompasses the Merit-Based Incentive Payment System (MIPS) and various Alternative Payment Models (APMs), as well as the Medicare Shared Savings Program (Shared Savings Program). Key provisions include six new MIPS Value Pathways (MVPs): ophthalmology, dermatology, gastroenterology, pulmonology, urology, and surgical care. CMS has included a Request for Information (RFI) on building upon the current MIPS MVPs framework for ambulatory specialty care. The Shared Savings Program includes proposals intended to drive growth in Accountable Care Organization (ACO) participation, particularly in rural and underserved areas.

The ACS is evaluating these and other proposals to determine the impact on surgery and will submit comments to CMS to help protect surgeons, their practices, and their patients. The rule and related fact sheet are available for public review. Contact regulatory@facs.org with questions.  

Also on July 10, CMS released the CY 2025 Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System proposed rules, as well as the Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) proposed rule. Read more about these in the July Advocacy Brief, which will be released on July 18.