The Centers for Medicare and Medicaid Services (CMS) released the 2025 Medicare Physician Fee Schedule (PFS) final rule on Nov. 1. Of note, the 2025 PFS conversion factor is $32.3465, a reduction of 2.83% from $33.2875 in 2024.

Overall, PFS reimbursement for cardiovascular services is projected to remain flat compared with 2024, with changes to policies and individual services roughly balancing out. Individuals and groups will see different impacts depending on patient populations and services offered.

Additional highlights include:

• Telemedicine Flexibility Extensions: Originating site location telehealth flexibilities that began during the COVID-19 public health emergency and were extended through 2024 by Congress will end, as required by current law. Starting Jan. 1, 2025, telehealth originating site rules will limit patient location to certain rural and underserved areas. Several bills under consideration in Congress would extend or make telehealth flexibilities permanent.
  
  Starting Jan. 1, 2025, two-way, real-time audio-only communication will satisfy the requirement for an interactive telecommunications system under specific circumstances when a patient cannot use or does not consent to using video technology. However, the distant site practitioner must still have audio-video capabilities.
• ASCVD Risk Assessment and Management G Codes: CMS finalized a proposal to create coding and payment for Atherosclerotic Cardiovascular Disease (ASCVD) risk assessment and risk management services. Risk management services would include the following: aspirin (or other medications), blood pressure management, cholesterol management and smoking cessation.
• Updated Code Values For New/Revised Services: The rule includes work and/or practice expense values for new/revised codes. No new codes were created nor existing codes revised expressly for cardiovascular services for 2025.
• Telehealth Home Address Enrollment: Through calendar year 2025, CMS will continue to permit a distant site practitioner to use their currently enrolled practice location instead of their home address when providing telehealth services from their home. They will consider this issue further for future rulemaking.
• Quality Payment Program: CMS added six new MIPS Value Pathways (MVPs) to be available for the 2025 performance year, along with revisions to all previously finalized MVPs.

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Keywords: Cardiology Magazine, ACC Publications, Centers for Medicare and Medicaid Services, U.S., Health Policy, Fee Schedules, Public Health