2025 CMS Physician Fee Schedule: Implications for Cardiology and the Urgent Need for Reform

 The 2025 CMS physician fee schedule (PFS) will reduce reimbursements for cardiologists by nearly 3%, raising alarms about the potential impact on patient care.

While reimbursements for coronary computed tomography angiography (CCTA) will double, other updates in the PFS are unfavorable for cardiologists.

The PFS conversion factor will decrease by 2.83%, and telehealth reimbursements, previously expanded during the pandemic, will be limited to rural and underserved regions only.

Cardiologists argue that their costs, such as labor, supplies, real estate, and patient complexity, align with hospital expenses, but their reimbursements continue to decline.

The current system's instability causes ongoing uncertainty, with temporary fixes often applied, leaving long-term issues unresolved.

For the past 20 years, physician reimbursements have not kept pace with inflation, making it increasingly difficult to sustain office-based practices amid rising expenses.

Legislation such as HR 10136 aims to create new payment models for office-based physicians, while HR 10073 offers temporary relief from the 2.83% PFS cuts.

The movement for site neutrality, which seeks to standardize Medicare payments across care settings, is gaining traction but requires further education and implementation.

Many experts stress that permanent Medicare fee schedule reforms are necessary to maintain patient access to quality care and stabilize medical practices.

Long-term solutions are crucial to address the systemic issues affecting physicians, particularly for managing the number one cause of death in the United States: cardiovascular disease.

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Key Take-Home Points

1. 2025 CMS fee schedule cuts reimbursements by 2.83%, causing significant concerns for cardiology practices.
2. Telehealth reimbursements will be restricted to rural and underserved regions starting in 2025.
3. Temporary fixes cannot address the systemic instability in physician reimbursements.
4. Stagnant reimbursements over 20 years have failed to account for inflation, threatening practice sustainability.
5. Legislation like HR 10136 and HR 10073 seeks to mitigate short-term impacts but lacks comprehensive solutions.
6. The movement for site neutrality in Medicare payments is growing but needs clarity and broader adoption.
7. Permanent reforms in the physician fee schedule are essential to ensure patient access and the viability of medical practices.