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Monday, September 23, 2024 04:06 PM

Family Physicians See Mixed Message in Proposed Medicare Fee-Schedule

AAFP Pushes for Removal of Restrictive Legislative Constraints

— Content from AAFP

In response the Centers for Medicare and Medicaid Services (CMS) releasing its 2025 Medicare physician fee schedule and Quality Payment Program proposed rule,  AAFP has written up detailed guidance on how the proposed changes could imperil family medicine practices across the country. While many of AAFP's continual asks have been included in the proposed rules, including clarification and improvement of the 25 modifier, the marquee issue is a familiar one: Without congressional intervention, family physicians can again expect a 2.8% Medicare payment reduction in 2025 — an untenable failure that threatens patients’ access to primary care.

The pay cut is owed to a smaller conversion factor (the number multiplied by the relative value of each code in the fee schedule to determine the Medicare payment rate) than this year’s. The reason for the lower conversion factor is the artificial constraint just mentioned: budget neutrality, the stipulation that CMS can’t raise payment in any area of the fee schedule without lowering it somewhere else. Only Congress can change or eliminate this. AAFP continues to advocate to all parties for solutions that reflect the value that family medicine provides. 

You can read more about the 2025 Medicare physician fee schedule and Quality Payment Program and AAFPs response here. 

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