On November 1, the Centers for Medicare and Medicaid Services (CMS) finalized the Medicare Part B Physician Fee Schedule (PFS) payment rate and other policy updates for Calendar Year (CY) 2025, which will become effective for items and services beginning January 1, 2025. The average payment rates under the PFS will be reduced by 2.93 percent in CY 2025, compared to the average amount these services were paid for most of CY 2024.
AHCA/NCAL has been advocating on this issue, including submitting a comment letter to CMS. We are also among the 129 supporting provider organizations of a bill that would increase the Medicare Part B PFS payments for CY25 by 4.73 percent above the rates finalized in this rule.
AHCA/NCAL has developed a detailed member-only summary highlighting key provisions in the final rule and the impact for members. Please note that a member log-in is required to view the summary.
For background, the Medicare Part B PFS is used to pay for certain medical services and items furnished on an outpatient basis, or for inpatients that are not otherwise covered under Part A. In a nursing facility, this includes physician, nurse practitioner, physical and occupational therapy, and speech-language pathology professional services as well as for portable x-ray, clinical laboratory, and other services.