2025 CMS Rates Proposed: Physician Fee Schedule Rates Decrease while OPPS Rates Increase
The Centers for Medicare & Medicaid Services (“CMS”) released its proposed rule for the 2025 physician fee schedule. As proposed, payment for services furnished under the 2025 Physician Fee Schedule (“PFS”) would be reduced by 2.93%. This amounts to a 2.8% reduction in the Physician Conversion Factor. All comments must be submitted by September 9, 2024. Conversely, CMS’s proposed rule on the 2025 outpatient prospective payment system (“OPPS”) rates proposes to increase payments by a net of 2.6%.
HHS Workplan Is Finally Here!
This week, the U.S. Department of Health and Human Services, Office of Inspector General issued its Work Plan. Among those items addressed are Medicare Payments for Clinical Diagnostic Laboratory Tests in 2023, State Directed Payments in Medicaid Managed Care, Medicaid Managed Care Capitation Payments on Behalf of Incarcerated Enrollees, and Followup Review of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided by Suppliers During Inpatient Stays.
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