The small wins for physicians inside CMS' 2025 payment schedule

CMS recently released its 2025 physician payment rule, which included a 2.83% cut to physician payments, marking the fifth consecutive year of cuts. 

While the cuts have been met with pushback from physician advocacy groups, a Dec. 23 news release by the American Medical Association noted that there were several points in CMS' final ruling that reflected the organization's positions. 

Here are three inclusions to the final rule supported by the AMA:

1. Extensions to telehealth. Telehealth extensions that were put in place during the COVID-19 pandemic were extended through March 2025 by Congress in a downsized funding bill. CMS will also allow for billing for telehealth services delivered via telephone and other audio-only devices. This rule specifically applies to patients who cannot or do not consent to use audiovisual technology for diagnosis, evaluation or treatment of a mental health or substance-use disorder and for monthly assessment of end stage renal disease.

CMS also extended the suspension of frequency limits on subsequent hospital and nursing facility telehealth visits and the ability of teaching physicians to provide virtual direct supervision and virtual supervision of residents when the resident provides telehealth services. Physicians who provide telehealth from their homes do not have to report their home address to Medicare. 

2. MIPS thresholds maintained. CMS did not increase thresholds for incurring a financial penalty under the Merit-based Incentive Payment System. The threshold will be maintained through 2025, which affects MIPS payments in 2027. 

CMS also modified its methodology for the MIPS cost-performance category with the goal of increasing scores for physicians whose average costs are near the median. 

3. More equity in cancer screening. CMS finalized its proposal regarding the expansion of coverage for colorectal cancer screenings. The rule will promote cancer prevention efforts in rural communities and in populations with higher rates of CRC, including Black and Native American communities. 

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