In this episode, Dr. Nisha Mehta is joined by Dr. Aaron Broadwell, rheumatologist and President of the Coalition of State Rheumatology Organizations (CSRO), to discuss the dangers of the proposed changes to payments for same-day E&M services and procedures in the Medicare Physician Fee Schedule. They also dig deep into not just how to advocate against it, but broaden the discussion about making the overall pot for physician compensation bigger rather than pitting physician specialties against each other.
They discuss:
- What CMS is proposing for Modifier 25 compensation changes and why reducing payment for the lower-valued same-day service by 50% could have major consequences for not physician practices, but for patients
- The very real – and dangerous – consequences of requiring patients to return for procedures on a separate day on wait times, costs, and delayed or missed diagnoses
- How continued Medicare reimbursement cuts could further threaten the sustainability of independent private practices, accelerate practice consolidation, Medicare and insurance opt-outs, and the loss of community care options for patients
- The Patients First Act and the larger problem of forcing specialties to compete for reimbursement within a fixed Medicare physician payment system
- How physicians (and patients!) can advocate effectively against changes regardless of whether they have time to lobby Congress in person
Anybody wanting to submit a comment before the commenting period closes on 9/14/26 should go to https://www.regulations.gov/document/CMS-2026-2377-0002/comment
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