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Call to Action: Urge CMS to Remove Proposed Payment Cut to Same-Day Services

The Michigan State Medical Society (MSMS) and more than 140 national and state medical organizations sent a letter urging the Centers for Medicare and Medicaid Services (CMS) to not to finalize its proposed 2027 Medicare Physician Fee Schedule (PFS) policy to reduce payment when medically necessary, separately identifiable evaluation and management (E/M) services (using modifier -25) are furnished on the same day as procedures with 0-, 10-, or 90-day global periods. However, CMS also needs to hear from individual physicians, Physician Organizations, and medical practices about how this policy would impact your operations and capacity to provide convenient and accessible care to your patients.

Under this proposal, the most expensive service (either surgical or E/M visit) would be paid 100 percent, and all other surgical procedures(s) or E/M visit(s) would be paid at 50 percent. This proposal is inherently unfair to office-based physicians who perform minor procedures in their office. MSMS has created two convenient methods for voicing your concerns:

  1.  Submit formal comments to CMS on the proposed rule (due by Monday, September 14, 2026) using the MSMS prepared template letter that can be edited to include personalized examples of how such a policy may impact your practice and patients.  The key asks of CMS are:

    • Do not finalize the proposed 50 percent payment reduction for services furnished on the same date as a separately identifiable O/O E/M visit reported with modifier -25;

    • Do not extend the policy to procedures furnished on the same date as inpatient or other E/M services; and

    • Address any genuine overlap through the established misvalued code and AMA/Specialty Society RVS Update Committee (RUC) valuation processes on a code-specific basis, rather than through a uniform, payment-level reduction, working with interested organizations where CMS believes specific codes do not fully account for overlap.

      When commenting, refer to file code “CMS-1848-P” and use one of the three following ways to officially submit your comments: 

       - Electronically: regulations.gov 

      - Regular mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1848-P, P.O. Box 8016, Baltimore, MD 21244-8016. 

      - Express or overnight mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1848-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.

  2. Use the MSMS Grassroots Action Center to ask your US Representatives and US Senators to encourage CMS leadership to withdraw this policy when it finalizes the proposed 2027 Medicare Physician Fee Schedule rule.

Please feel free to contact Stacey Hettiger at shettiger@msms.org or 517-336-5766 if you have any questions or to share other concerns with the proposed rule.

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