ACR Speaks Against Repeated Cuts to Medicare Reimbursements Save

The American College of Rheumatology (ACR) has submitted its comments to the Centers for Medicare and Medicaid Services (CMS) regarding the proposed CY 2025 Medicare Physician Fee Schedule and Quality Payment Program rule and its impact on rheumatologists and rheumatology interprofessional team members’ ability to provide care to the 53 million Americans living with rheumatic disease.

In its comments, ACR expressed concern that CMS is again proposing further cuts to the conversion factor for the fifth consecutive year. The letter notes many physicians in the field of rheumatology are already facing challenges from burnout, early retirement or departures, and staffing shortages and will also be disproportionately impacted by the growing and aging Medicare population. Given this impact, ACR strongly urged CMS not to proceed with the proposed cut and instead called for appropriate reimbursement for its members and the services they provide.

The letter also notes that access to high-quality rheumatic disease care may be negatively impacted if CMS fails to permanently extend all regulatory flexibilities on telemedicine reimbursement. Telemedicine has expanded care to areas where the availability of rheumatologists may be severely limited and has also allowed individuals facing mobility or transportation issues easier access to care. However, many telemedicine provisions are set to expire at the end of the year unless policymakers take action. ACR asked CMS to remove all telehealth payment parity restrictions and barriers to interstate licensure so providers can treat beneficiaries across state lines.

ACR applauded the continued use of the add-on code, G2211, to account for visit complexity and the inherent resource costs clinicians incur when managing a patient’s overall health or treating a single, serious, or complex chronic condition.

Finally, ACR weighed in on proposed quality payment program changes and reiterated support for initiatives to advance quality care, but encouraged CMS to continue to engage with ACR and other specialty societies to ensure these programs are streamlined and do not create additional unworkable administrative burdens for care teams.

See the ACR’s full comments, including specific feedback on billing codes, payment limits, and changes to the Merit-based Incentive Payment System (MIPS) Value Pathway (MVP).