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Medicare Physician Fee Schedule Final Rule Includes Conversion Factor Decrease
Nov. 1, 2024
The Centers for Medicare and Medicaid Services (CMS) released the 2025 Medicare Physician Fee Schedule (MPFS) final rule with fact sheet Nov. 1. The agency describes changes to payment provisions and to policies for the Medicare Shared Saving Program, Prescription Drug Inflation Rebate Program and provider overpayments.
The American College of Radiology® (ACR®) created an initial summary of all provisions of the MPFS proposed rule that have a direct impact on imaging practices.
CMS finalized the 2025 conversion factor at $32.3465 compared to the 2024 conversion factor of $33.2875. This was calculated by removing the temporary increases provided by the Consolidated Appropriations Act of 2023 and the Consolidated Appropriations Act of 2024, then applying a positive 0.02% budget neutrality adjustment. The final budget neutrality adjustment was slightly lower than the 0.05% adjustment indicated in the proposed rule released in July.
CMS estimates an overall impact of the MPFS proposed changes to diagnostic radiology, nuclear medicine and radiation oncology to be a neutral 0%, while interventional radiology will see an aggregate decrease of 2%.
In a press statement released by the College earlier this week, ACR CEO Dana Smetherman, MD, MPH, MBA, FACR, said, “As physician payment legislation continues to evolve [to address the negative adjustment], lawmakers must continue to work with the House of Medicine to enact this legislation and Medicare payment reform that stabilizes the practice environment and safeguards patient access to lifesaving care.”
In addition to payment provisions, the rule includes coverage of screening CT colonography (CTC) for colorectal cancer for Medicare beneficiaries. ACR has long advocated for Medicare coverage of screening CTC and applauds the decision.
A detailed summary will be provided in the coming weeks.
For questions about the final rule, contact Katie Keysor, ACR Senior Director of Economic Policy.
The American College of Radiology® (ACR®) created an initial summary of all provisions of the MPFS proposed rule that have a direct impact on imaging practices.
CMS finalized the 2025 conversion factor at $32.3465 compared to the 2024 conversion factor of $33.2875. This was calculated by removing the temporary increases provided by the Consolidated Appropriations Act of 2023 and the Consolidated Appropriations Act of 2024, then applying a positive 0.02% budget neutrality adjustment. The final budget neutrality adjustment was slightly lower than the 0.05% adjustment indicated in the proposed rule released in July.
CMS estimates an overall impact of the MPFS proposed changes to diagnostic radiology, nuclear medicine and radiation oncology to be a neutral 0%, while interventional radiology will see an aggregate decrease of 2%.
In a press statement released by the College earlier this week, ACR CEO Dana Smetherman, MD, MPH, MBA, FACR, said, “As physician payment legislation continues to evolve [to address the negative adjustment], lawmakers must continue to work with the House of Medicine to enact this legislation and Medicare payment reform that stabilizes the practice environment and safeguards patient access to lifesaving care.”
In addition to payment provisions, the rule includes coverage of screening CT colonography (CTC) for colorectal cancer for Medicare beneficiaries. ACR has long advocated for Medicare coverage of screening CTC and applauds the decision.
A detailed summary will be provided in the coming weeks.
For questions about the final rule, contact Katie Keysor, ACR Senior Director of Economic Policy.