Zotec Partners

Congress Eyes Medicare Payment Changes in Budget Reconciliation Bill
May 20, 2025 by Megan Boyd

A sweeping reconciliation bill introduced in the House includes a major shift in Medicare physician payment policy. The proposal would tie future payment updates to the Medicare Economic Index (MEI)—75% in 2026 and just 10% in 2027 and beyond. It also eliminates the Medicare Access and CHIP Reauthorization Act (MACRA) differential update for alternative payment model participants. While this marks the first permanent update to the Medicare Physician Fee Schedule since 2015 and aligns with MedPAC recommendations, it leaves in place the -2.83% cut that took effect on January 1, 2025. 

Key changes in the proposal: 

  • Links physician payment updates to 75% of MEI in 2026 and 10% in 2027+
  • Removes MACRA’s differential update for APM participants
  • Does not reverse the 2025 -2.83% payment cut

Since 2001, Medicare physician pay has dropped 33% when adjusted for inflation, squeezing independent practices and threatening access to care—especially in rural and underserved areas. We will continue to provide updates as the bill moves through Congress in the coming weeks, but in the meantime, you can make your voice heard. Take action today by sending your members of Congress a message, urging them to provide a Doc Fix for 2025.  


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