2025 Medicare Physician Fee Schedule and Advocacy Opportunity

On Nov. 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued its annual 2025 Medicare Physician Fee Schedule (PFS) that announces finalized regulatory changes for Medicare payments under the PFS effective on or after Jan. 1, 2025. Unfortunately, one of the biggest areas of concern is the 2.83% reduction in the Medicare conversion factor. As an example of what AANEM members are facing as a result of the reduced conversion factor, below is a table of the reduction in reimbursement from Medicare for commonly billed EDX codes:

While the reduction stems from statutorily mandated budget neutrality rules, AANEM has urged CMS to work with Congress and the medical community to secure a positive update to the Medicare conversion factor. This adjustment is essential to offset the negative impacts of inflation on physicians, medical practices, and patient access to care.  

In the 118th Congress, AANEM supported several bipartisan bills aimed at addressing the persistent failure of physician reimbursement rates to keep pace with inflation and rising practice costs. These included H.R. 6683, Preserving Seniors’ Access to Physician Act of 2023; H.R. 6371, Provider Reimbursement Stability Act of 2023; and H.R. 2474, Strengthening Medicare for Patients and Providers Act. Unfortunately, no healthcare-related legislation was passed before the conclusion of the session. 

AANEM remains committed to advocating for physician reimbursement and now supports the newly introduced H.R. 879, Medicare Patient Access and Practice Stabilization Act. This bill would fully halt the latest round of payment cuts and provide a critical 2% payment increase for physicians from April 1 through Dec. 1, 2025. 

The American Medical Association (AMA) has also been a longstanding advocate for Medicare physician payment reform.  Physicians are encourage to take action by contacting their lawmakers in support of H.R. 879. More details on the AMA’s advocacy initiatives can be found in the AMA Advocacy Impact Report. 

Questions and comments are always welcomed by the AANEM policy department: policy@aanem.org.