The OrthoForum and American Alliance of Orthopaedic Executives urged CMS to reconsider several policies in the CY 2027 Medicare Physician Fee Schedule Proposed Rule, including arthroplasty payment reductions and a proposed 50% Modifier 25 payment reduction, according to comments the groups submitted to CMS and shared with Becker’s.
The OrthoForum modeled approximately 19.7 million services and estimated Medicare PFS payments would decline from approximately $1.721 billion in 2026 to $1.634 billion in 2027, a reduction of approximately $86.8 million, or 5%. Major arthroplasty services accounted for approximately $58.4 million, or 67.3%, of the modeled reduction.
The American Alliance of Orthopaedic Executives, which represents over 1,300 members and 660 medical practices, also urged CMS not to finalize the proposed 50% payment reduction for separately identifiable evaluation and management services furnished on the same day as certain procedures.
The groups also raised concerns about the ambulatory specialty model and proposed changes involving the indirect practice cost index. The OrthoForum urged CMS to delay implementation of the ASM until at least Jan. 1, 2028.
The American Alliance of Orthopaedic Executives also raised concerns about remote physiologic monitoring and remote therapeutic monitoring services and urged CMS to maintain a traditional merit-based incentive payment system reporting option.
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