Overview
On Nov. 1, 2024, the U.S. Centers for Medicare & Medicaid Services (CMS) released the 2025 Medicare Physician Fee Schedule (MPFS) final rule. CMS finalized a CY 2025 PFS conversion factor of $32.35, representing a 2.83% decrease (or $0.94) from the current conversion factor. This cut is a result of the expiration of a 2.93 percent temporary update to the conversion factor at the end of 2024 and a 0 percent baseline update for 2025 under the Medicare Access and CHIP Reauthorization Act. Eligible physicians who fail to comply with the requirements of the Merit-based Incentive Payment System (MIPS) in 2025 will also be subject to a penalty of up to 9% of their Part B Medicare payments. The AANS and the CNS provided detailed comments on the CMS 2025 MPFS proposed rule on September 9, 2024.
Additional resources on the final rule from CMS are provided below:
- CY 2025 MPFS Final Rule: Link
- MPFS Press Release: Link
- MPFS Fact Sheet: Link
- Quality Payment Program (QPP) Fact Sheet: Link (to download)
- 2025 Finalized Merit-Based Incentive Payment System (MIPS) Value Pathways
(MVPs): Link (to download) - Medicare Shared Savings Program (MSSP) Fact Sheet: Link
- Medicare Prescription Drug Inflation Rebate Program: Link
The following includes highlights of issues of interest to neurosurgery
Reimbursement Issues
Global Surgical Codes
For over a decade since the largely discredited 2012 HHS OIG Report on the number and level of E/M visits in global surgical procedures, CMS has spent time and resources on attempts to dismantle the long-standing global surgical payment convention for surgery. CMS has made a number of efforts to seek data on E/M visits provided to patients after having a procedure reported within a global period. In 2025, for 90-day global surgical services, CMS has finalized the following requirements.
