The Centers for Medicare and Medicaid Services (CMS) recently published the proposed rule for the Calendar Year (CY) 2027 Medicare Physician Fee Schedule, which included a proposed payment reduction for services reported on the same day with Modifier 25. CMS’s proposal would cut payment even when both services are appropriate and properly documented. Practices facing continued Medicare payment reductions may need to limit the number of Medicare beneficiaries they can serve, reduce services or staffing, delay investments in equipment and technology, consolidate with larger health systems, or, in some cases, close altogether. 

For patients, these pressures could mean fewer physician choices, reduced access to community-based care, and greater difficulty getting timely, coordinated care close to home. To learn about the proposal or APMA's advocacy efforts, please refer to our Modifier 25 landing page.

Please urge CMS to withdraw this proposal and protect Medicare patients’ access to timely, appropriate care.