LUGPA Policy Alert: CMS Finalizes 2025 Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) published the MPFS and OPPS fee schedules, which will take effect on January 1. In the comment phase, LUGPA, along with essentially every other medical organization, expressed significant concern regarding the ongoing cuts to the PFS conversion factor, which contribute to the continued erosion of physician practice in America.

LUGPA strongly opposes the finalized reduction in the PFS conversion factor, which presents severe challenges for independent practices. This decrease imposes an undue financial burden on specialty providers and threatens the sustainability of independent practices, ultimately limiting access to care for Medicare beneficiaries.

Notably, the PFS conversion factor will decrease by 2.93 percent, resulting in a new rate of $32.35 for 2025. This adjustment is a response to a statutory requirement for a 0 percent update, the expiration of a temporary payment increase for 2024, and necessary budget neutrality adjustments. In contrast, OPPS payment rates will see a 2.9 percent increase, reflecting the market basket update minus a productivity adjustment.

The increase in OPPS payment rates underscores the need for parity and stable reimbursement for office-based practices. LUGPA will continue to advocate for comprehensive reform to the PFS to ensure fair and sustainable reimbursement levels.

For further details, please refer to the following CMS resources:

• CY 2025 PFS Press Release
• CY 2025 PFS Fact Sheet
• CY 2025 Quality Payment Program Fact Sheet
• CY 2025 OPPS Press Release
• CY 2025 OPPS Fact Sheet

LUGPA will continue to analyze the impacts of these changes and advocate for policies that support independent urology practices and patient-centered care.