The Medicare reimbursement rates for 2025 remain unchanged as a result of the Continuing Resolution (CR) passed by the U.S. Congress and signed on March 15. Thus, the downward spiral of Medicare reimbursement continues with physicians receiving nominally 2.83% less this year than in 2024.
Radiology practices will see somewhat different results depending on their practice pattern, as we reported in our recent article analyzing the real impact of the Medicare Physician Fee Schedule (MPFS). We calculate that the Professional Component reimbursement would decrease by 2.16%, while global reimbursement at an imaging center would decrease by 3.55%, both on a weighted-average basis.
Sandy Coffta.
The CR does contain two provisions related to physician practices. One is a simple extension through September 30 of the telehealth flexibilities that were scheduled to end on March 31. These include removing the geographic requirements and expanding the eligible originating sites for telehealth; expanding the practitioners eligible to provide telehealth services; and allowing audio-only telehealth services.
The other provision allows the MPFS to remain at its current level through September 30 by extending the 1.0 work floor factor that is used to calculate the geographic adjustment of the fee schedule. The Geographic Adjustment Factor is explained in more detail in our recent article. Without the CR, some parts of the country would have seen their Medicare reimbursement reduced on April 1 by up to 2.7% on top of the 2.83% across-the-board cut.
While the CR failed to provide any increase in the MPFS, other legislation continues to be awaiting action in Congress. H.R. 879, the “Medicare Patient Access and Practice Stabilization Act of 2025,” would adjust the MPFS conversion factor upward by 6.62% resulting in a 3.79% increase over the 2024 rate. The bill, which has the bipartisan support of at least 143 cosponsors, as it is written would take effect from April 1 to December 31, but its passage is not likely to occur before May as part of a budget reconciliation package.
Physician advocacy groups such as the Radiology Business Management Association (RBMA), the American College of Radiology (ACR), and the Medical Group Management Association (MGMA) urge passage of the bill, which would provide a permanent solution to the downward fee schedule slide. The MGMA website has an easy link for anyone to contact their representatives about the importance of this legislation. We will continue to monitor any progress on the MPFS legislation, along with any other issues that will affect your reimbursement.
Sandy Coffta is vice president of client services at Healthcare Administrative Partners.
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