Imaging Policy & Legislation

Will Congress Stop Medicare Cuts?

Radiologists find themselves once again in a familiar position, facing CMS cuts in Medicare and Medicaid physician payments for 2025. A new analysis by revenue cycle management company Healthcare Administrative Partners details the impact of the reductions, as well as other reimbursement changes set to take effect next year. 

CMS has been driving down radiology reimbursement for years, a trend widely seen as part of the agency’s effort to shift funding from medical specialties to primary care. 

  • That’s having an impact on physician pay, as a study last week found that private-practice diagnostic radiologists have seen inflation-adjusted salaries decline at a -1% annual rate since 2014. 

That trend is set to continue in 2025, with CMS publishing its final rule for the Medicare Physician Fee Schedule that affirms most of the changes it proposed in July. In the new article, HAP’s Sandy Coffta unpacks the changes, which include … 

  • A new conversion factor of $32.3465 (down from $33.2875).
  • Payment reductions of -2.8% for radiology and nuclear medicine, and -4.8% for interventional radiology.

But not all of the changes are negative. Other 2025 policies that affect radiology include …

  • Reimbursement for CT colonography for Medicare beneficiaries at a rate of $108.68 for the professional component.
  • New codes for reporting MRI safety procedures.
  • New quality category measures in the Merit-based Incentive Payment System.

CMS proposed similar cuts last year, but Congress swooped in at the last minute to roll them back with the Consolidated Appropriations Act, which applied a positive 2.93% upward adjustment. 

  • Several bills in Congress now would likewise stave off the 2025 reductions (H.R. 2474 and H.R. 10073), but time is running out to pass them before the current Congressional session expires on January 3, 2025. 

The Takeaway

Will Congress once again ride to the rescue and stave off Medicare reimbursement cuts, as it did a year ago? Or will things be different this time, given the political turbulence that’s shaking Washington, DC? We’ll find out in a few weeks.

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