FSR Joins Rheumatology Coalition in Opposition to Proposed Modifier -25 Payment Changes

The Florida Society of Rheumatology has joined a broad coalition of rheumatology organizations in expressing concern about a proposed change to Medicare payment policy that would reduce payment for medically necessary, separately identifiable evaluation and management (E/M) services performed on the same day as certain procedures.

The proposal, included in the CY 2027 Medicare Physician Fee Schedule, could affect rheumatology practices when a patient requires both a procedure and significant evaluation and management during the same visit. The coalition emphasized that these encounters involve substantial cognitive work—including assessing disease activity, reviewing laboratory and imaging results, reconciling medications, adjusting therapies, discussing treatment risks and benefits, and coordinating ongoing care.

The coalition expressed concern that the proposed policy could lead practices to schedule procedures separately, creating additional appointments for Medicare patients, increasing transportation and caregiver burdens, delaying treatment, and potentially increasing overall healthcare costs.

The letter urges CMS to work with physicians, specialty societies, MedPAC, and other stakeholders to develop evidence-based payment policies that accurately reflect clinical practice while maintaining appropriate stewardship of Medicare resources.

The Florida Society of Rheumatology is proud to join this national advocacy effort on behalf of Florida rheumatologists and the patients they serve.

Read the letter