CMS Released the Annual Medicare Physician Fee Schedule Proposed Rule

On July 10, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) proposed rule for CY 2025 (CMS-1807-P). The rule updates payment policies and payment rates for Part B services furnished under the MPFS, as well as makes changes to the Quality Payment Program (QPP) for CY 2025. The rule in its entirety and the addenda, including Addendum B, which lists the proposed RVUs for each CPT ® code can be found here. Comments are due September 9. The final rule will be released in early November.

The proposed rule discusses several significant policy changes, including creating a new code to address the global surgical package policy, requiring use of modifiers for 90-day global surgeries, redefining telehealth services to include audio-only services, and declining to accept and pay for the new CPT codes used to 16 of the 17 telemedicine E/M codes. The agency
instead would like providers to continue to bill for telehealth E/M services using appropriate modifiers, and any associated place of service codes.

Conversion Factor for 2025
The conversion factor for 2025 is set to decrease by approximately 2.80% from $33.2875 to $32.3562. The cut is primarily driven by the expiration of the conversion factor increase that Congress passed in March.