Physicians who participate in the Medicare program face growing economic challenges due to a confluence of uncertainties from the pandemic, Medicare payment cuts, lack of inflationary updates, and significant administrative barriers. Adjusted for inflation, Medicare physician payments have decreased by 33% since 2001. Physicians experienced a 2% cut in Medicare payments in 2024, a 2.8% cut in 2025 - and even with a conversion factor increase proposed in 2026, many specialties will face even deeper cuts from other payment policy proposals. Continued erosion of Medicare payments to physicians will force many doctors to make tough decisions — potentially limiting seniors’ access to care and drastically impacting initiatives to support healthcare for rural and underserved communities.
Medicare Updates Compared to Inflation in Practice Costs (2001-2025)
Adjusted for inflation in practice costs, Medicare physician payment declined 33% from 2001 to 2025.
Looming Cuts to Medicare
As physicians face uncertainty about the financial viability of their practices due to low Medicare reimbursements, physician participation in Medicare is declining. Just 65% of physicians will accept new Medicare or Medicaid patients and continue to treat their current patients, according to Medscape’s 2023 Physician Compensation Report. Congress has repeatedly acted to protect providers, but a long-term solution is essential. Physicians are currently facing cuts of:
- 4% — from the Statutory PAYGO sequester
- 1.25% — from a phasing-out bonus to Medicare reimbursements designed to offset changes to E/M codes
- Up to 10% — for certain specialties due to changes in E/M codes
- More than 20% — for certain specialties due to changes in CMS’ clinical labor pricing formula
- In addition, Medicare reimbursement payments do not account for inflation, leaving physicians behind as practice costs rise
Ask Congress to Act to Fix the Broken Medicare Physician Reimbursement System
Congress must act now to reverse harmful cuts to Medicare reimbursement rates that threaten physicians and their patients. On January 1, 2025, a 2.83% cut to Medicare Physician Fee Schedule payments took effect, reducing reimbursement for interventional cardiologists and other physicians. If left unaddressed, these cuts will exacerbate physician shortages, increase patient wait times, and push more independent practices out of business.
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Challenge Payment Erosion, Which Puts Access to Medicare in JeopardySCAI is demanding that Congress increase support for physicians who are juggling the delivery of healthcare to seniors and rural and underserved communities while facing the financial pressures of rising inflation and medical practice costs, increasing burnout in the medical profession, and the pandemic's lingering impact. Contact Your Representative |
