22 Jul 2025 CMS Proposed Rule | MPFS

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released the proposed Medicare payment rates under the Physician Fee Schedule (PFS) for CY 2025. These updates include several significant changes impacting radiation oncology and other specialties. Regina Hargrove, our Revenue Cycle/Authorizations Consultant, has outlined the top three things providers need to know for 2025.

Here are the Top 3 Things Providers Need to Know about CMS Proposed Rules for 2025

1. 1. Payment Rate Reduction: The proposed Physician Fee Schedule (PFS) for 2025 includes a 2.93% decrease in the conversion factor, impacting overall payment rates.
   2. Telemedicine Physician Supervision: CMS proposes extending the allowance of virtual presence for direct supervision through real-time audio and video technology until December 31, 2025, enhancing flexibility for telehealth services.
   3. Complexity E&M Add-On Code: Starting in CY 2025, Medicare proposes allowing payment for the outpatient E/M visit complexity add-on code (G2211) when reported on the same day as preventive services, supporting comprehensive patient care.

Comments must be received no later than 5 pm on September 09, 2024. Commenting electronically is the easiest and can be completed at https://www.regulations.gov/commenton/CMS-2024-0256-0001.