From American Medical Association (AMA) On December 20th the House and Senate avoided a government shut down and passed a continuing resolution to keep federal agencies and programs operating until March 14. Most of earlier proposed health care package, including…
2024 CMS Improper Payment Data Released
Congress Fails to Avert Cut to Medicare Physician Reimbursement
As of January 1, 2025, the Medicare Physician Fee Schedule (MPFS) conversion factor was reduced by 2.83 percent to $32.3465 from $33.2875 in 2024. The cut to Medicare physician services went into effect after Congress failed to address the pay cut to Medicare physicians in the scaled-back end-of-year package passed on December 20, which averted a government shutdown by funding the government through March 14.
Congress had originally considered a provision to mitigate the conversion factor cut by 2.5 percent, but this was stripped from the package when President-elect Donald Trump objected to the scope of package, which included appropriations, health, agriculture, and other provisions. Key members of Congress, including GOP Doctors Caucus member Rep. Greg Murphy (R-NC), have already called for Congress to pass a retroactive physician reimbursement fix when they address government funding in March.
Besides providing a short-term extension of government funding, the package also extended the Medicare telehealth flexibilities through the end of March.
Documentation for E/M Services Crucial to Timely and Appropriate Reimbursement
As the new year begins, we want to remind our members that documentation for evaluation and management (E/M) services provided to patients is the cornerstone of timely and appropriate reimbursement. Insufficient documentation may lead to delays in payment, requests for patient records (a time-consuming process), or worse, audits that can tie up valuable staff and physician resources.
To ensure staff, physicians, and other stakeholders in your practice are up to date on correct E/M coding and documentation, AAOA is providing the website links which provide information on Medicare coding rules, and link to resources from the American Academy of Family Physicians and the American Medical Association on coding for E/M services. If you have questions or need additional information, please contact AAOA staff.
Evaluation and Management Services Resources:
