Medicare Patients' Access to ENT Care Is at Risk
50%
Payment Cuts to Vital Care
For additional medically necessary services delivered during the same visit.
−10%
Overall Payment Reductions
Projected impact for otolaryngologists in non-facility settings, according to CMS.
Three ways this policy affects your practice:
The proposed payment reduction could have significant consequences for how otolaryngologists deliver care and how patients access it.
Penalize efficient, one-visit care.
The proposal will lead to patient care being split across multiple appointments, delaying treatment and increasing burdens for Medicare beneficiaries and their caregivers.Significantly reduce reimbursement.
CMS's own estimates suggest that otolaryngologists in the non-facility setting will realize a –10% impact to Medicare reimbursement, with direct impact varying across practice settings, largely because of this policy change.Threaten access to specialty care.
Many physician practices will be unable to absorb this steep cut and will have to cut back on staff and services. This will leave patients with longer waits, fewer choices, and reduced access to care.Our Ask
Urge Members of Congress to call on CMS to withdraw the proposed Modifier 25 payment reduction before the 2027 Medicare Physician Fee Schedule is finalized.
Advocate
Contact your representatives on Capitol Hill and ask them to urge CMS not to finalize this proposal.
Write
Submit comments and testimony to CMS by September 14. The AAO-HNS has a template for you to use. Add in your personal story and relevant clinical scenarios.
Educate
Start the conversation with your patients and urge them to get involved in protecting their access to quality otolaryngologic care.
Share
Share this issue with your hospital leadership, practice administrators, coding staff, and billing team so they understand the potential impacts.
Understand
Evaluate your payer mix and practice patterns to determine this proposal's specific impact on you.
Take It to Your Representative
Download the one-page policy brief for key facts, projected impact, and a clear congressional ask.
Contact Our Health Policy Team
Have questions about the proposed policy or how it may affect your practice? The AAO-HNS health policy team is here to help.