CMS Finalizes Unacceptable 2.83 Percent Cut to Physician Payments in 2025

GI Societies are fighting to prevent reimbursement cuts – you can help! 
 
The final 2025 Medicare Physician Fee Schedule and the Hospital Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) rules were released on Nov. 1. 
 
Key takeaways for GI: 
 
Physician payments decline: Our societies will continue to urge Congress to reverse the 2.83 percent cut to Medicare physician reimbursement announced in the 2025 fee schedule. This cut is based on a proposed 2025 physician conversion factor of $32.3465 from the current CY 2024 conversion factor of $33.2875. This is the fifth year in a row that the conversion factor is facing a cut – a more than 10% decrease since 2020. 
 
Tell Congress these cuts are unsustainable! Urge them to pass H.R. 10073, a bipartisan bill which would reverse the cut and result in a 2025 payment update of 4.73 percent.  

 

Hospital and ASC payments increase: Conversion factors increase 2.9 percent to $89.90 for hospitals and $55.06 for ASCs that meet applicable quality reporting requirements. 
 
CMS proposes to largely end COVID-19 era telehealth flexibilities: COVID-19 telehealth flexibilities will remain in place until the end of CY 2024. However, beginning January 1, 2025, CMS is proposing that absent Congressional action the statutory restrictions on geography, site of service, and practitioner type that existed prior to the COVID-19 PHE will go back into effect. The GI societies are actively participating in these policy discussions to ensure long-term access to telehealth services for your patients. 
 
CMS does not accept new telemedicine office visit codes: For CY 2025, CMS finalized its proposal not to pay separately for new CPT codes 98000-98015 to describe telemedicine services since they do not believe there is a programmatic need for these codes.  
 
Expanded Colorectal Cancer Screening: CMS finalized several policies to update and expand coverage of colorectal cancer (CRC) screening, including adding blood-based biomarker tests to the “Complete CRC Screening” policy that ensures a follow-on colonoscopy is covered without patient cost-sharing. 

 

 


About Gastrointestinal Endoscopy
Gastrointestinal endoscopic procedures allow the gastroenterologist to visually inspect the upper gastrointestinal tract (esophagus, stomach and duodenum) and the lower bowel (colon and rectum) through an endoscope, a thin, flexible device with a lighted end and a powerful lens system. Endoscopy has been a major advance in the treatment of gastrointestinal diseases. For example, the use of endoscopes allows the detection of ulcers, cancers, polyps and sites of internal bleeding. Through endoscopy, tissue samples (biopsies) may be obtained, areas of blockage can be opened and active bleeding can be stopped. Polyps in the colon can be removed, which has been shown to prevent colon cancer.

About the American Society for Gastrointestinal Endoscopy
Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal endoscopy. ASGE, with almost 16,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit Asge.org and ValueOfColonoscopy.org for more information and to find a qualified doctor in your area.

 

American Society for Gastrointestinal Endoscopy
3300 Woodcreek Drive Downers Grove, IL 60515
P (630) 573-0600
F (630) 963-8332

Media Contact

Andrea Lee
Director of Marketing and Communications
630.570.5603
ALee@asge.org