‘Less and Less Reimbursement’: CMS Proposes More Part B Medicare Cuts

Average payment rates are set to decrease by 2.93% under the proposed 2025 Physician Fee Schedule (PFS), a change that incorporates the zero percent overall update required by statute.

The Centers for Medicare & Medicaid Services (CMS) announced the proposed rule on Wednesday.

Cynthia Morton, executive vice president for Advion Advocates, said this amounts to a 2.8% reimbursement reduction when nursing homes bill for Medicare Part B services, including rehabilitation therapy.


“This continues the downward reduction in reimbursement for essential services, especially for dually eligible residents where Medicare Part B covers doctor visits, rehab therapy and other services,” said Morton. “This continues the pressure on providers to continue providing services with less and less reimbursement.”

The proposed rule would also expand caregiver training services, strengthen primary care and expand access to behavioral health, along with maintaining telehealth flexibility among care settings, including nursing homes.

“We are taking lessons learned from numerous CMS Innovation Center models to strengthen primary care teams and accountable care organizations, allowing them to better meet the unique needs of every person with Medicare,” Meena Seshamani, Deputy CMS Administrator and Director of the Center for Medicare, said in a statement.


Congress is considering a more permanent reform of the PFS, Morton said, but it’s unclear whether it can accomplish that at the end of this calendar year, or if it’s ready to take the pressure off providers in 2025.

The cut comes after a 1.25% reduction for this year and amounts to a proposed 2025 PFS conversion factor of $32.36, a 93-cent decrease compared to the current 2024 conversion factor of $33.29.

Companies featured in this article: