CMS announced the final rules for the 2025 physician fee schedule, the hospital outpatient prospective payment system (OPPS) and the Ambulatory Surgical Centers. Within these rules, CMS is finalizing new coding and payment policies for advanced primary care management services, advancing maternal safety standards, removing barriers to expand access to care for those formerly incarcerated and others in underserved communities, and setting policies to reduce the use of opioids and to increase access to high-cost drugs in tribal communities.
Physicians will see finalized average payment rates reduced by 2.93% in CY 2025 compared to the average payment rates for most of CY 2024, while payment rates for hospital outpatient and ASC services will increase by 2.9% in CY2025.
You can find more at the links below. Please contact me at (insert) with questions or if you’d like to learn more.
FINAL FULL PACKAGE: Calendar Year (CY) 2025 Physician Fee Schedule (PFS) Final Rule CMS-1807-F
Web links:
- Press Release: https://www.cms.gov/newsroom/press-releases/hhs-finalizes-physician-payment-rule-strengthening-person-centered-care-and-health-quality-measures
- PFS Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2025-medicare-physician-fee-schedule-final-rule
- MSSP Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2025-medicare-physician-fee-schedule-final-rule-cms-1807-f-medicare-shared-savings
- QPP Fact Sheet and FAQs: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3057/2025-QPP-Policies-Final-Rule-Fact-Sheet.pdf
- IRA Fact Sheet: https://www.cms.gov/inflation-reduction-act-and-medicare/inflation-rebates-medicare
- Federal Register: https://www.federalregister.gov/public-inspection/2024-25382/medicare-and-medicaid-programs-calendar-year-2025-payment-policies-under-the-physician-fee-schedule