On September 11, the Endocrine Society submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the Medicare Physician Fee Schedule (MPFS) proposed rule for Calendar Year 2027.
This rule, which is published annually, updates the payment policies and payment rates for Part B services furnished under the MPFS. This year’s rule, if finalized, would result in a 2.5% increase for the endocrinology specialty, but would also result in an overall decrease of 2.5% to the conversion factor for all physicians. Congressional intervention is necessary to update the conversion factor, and the Society continues to urge Congress to pass legislation providing an annual inflationary update to the MPFS tied to the Medicare Economic Index (MEI) that would override the rule.
The Society commented on several provisions in the rule that are important to endocrinologists. CMS has proposed creating a new practice expense equipment item for Fine Needle Aspiration (FNA), ER130 (“Fine Needle Aspiration portable ultrasound”). The Society advocated for this update to the practice expense inputs for FNA services and we worked with other medical societies to push for this change at the CPT and RUC.
The Society supports this change which is an important win for endocrinologists who perform FNAs. CMS has also proposed deleting the recently created G2211 complex care code and creating a new modifier code (MOD1) to take its place. The modifier, when appended to an appropriate E/M code, will increase payment by 16% of the value of the reported E/M CPT code. However, we are deeply concerned about the impact this will have on work RVUs, particularly for endocrinologists and other physicians who practice at larger hospital systems and universities.
This proposed change would result in a loss of work RVUs for those who practice at larger systems. In our letter, we urge the agency not to finalize this proposal and to keep the G2211 code. Finally, we are asking CMS not to finalize a proposal that would reduce payment when using a Modifier 25 code under certain circumstances when being billed for an E/M visit.
The Endocrine Society staff worked closely with the Clinical Affairs Core Committee (CACC) to draft our comments. We thank the committee for their feedback and collaboration on this important issue. The final rule is expected to be released by early November at the latest. You can read the letter we submitted at: endocrine.org/advocacy/society-letters.
