Turn the Tables on Physician & Quality Pay Cuts

Physician Pay Cuts

The Medicare physician pay cuts continue with a 2.83% reduction for 2025. Pay cuts at a time when financial and physician shortage concerns are at an all-time high. The "Medicare Patient Access and Practice Stabilization Act" proposed to reverse the cuts is under review, with no definitive action yet.

The Relative Value Units (RVUs) conversion factor has barely increased since 1992. $31.00 to $32.36. RVUs are weights that determine how much a physician is paid for a service. RVUs are used in the Medicare Resource-Based Relative Value Scale (RBRVS).?

In summary, RVUs are used to calculate how much to pay physicians for services like office visits and surgical procedures.?The total RVU is multiplied by the Medicare conversion factor (currently $32.36 in 2025).

Types of RVUs

• There are three types of RVUs: physician work RVUs (wRVUs), practice expense RVUs, and professional liability insurance RVUs.?
• The total RVU is the sum of all three types of RVUs.?

If RVUs had increased at a normal rate each over the last 33 years (1992 to 2025), that $31 would be $64. (Credit to Dutch Rojas Post)

Quality Bonus Reductions

For payment year 2025, qualified providers participating in Advanced Alternative Payment Models (AAPMs) will receive a 3.5% lump-sum bonus based on their previous year's Medicare Part B payments, marking a decrease from the 5% previously available.

The 2025 Merit-Based Incentive Payment System (MIPS) payment adjustment, determined by the 2023 final score, will affect payments made for services in calendar year 2025, also referred to as the 2025 MIPS payment year. These adjustments are made on a claim-by-claim basis.

In 2025, MIPS payment adjustments will range from -9% to approximately +2.15%.

MIPS Guide 2025

Instead of waiting for Congress to act, Let's Talk Revenue

Kris Gates, [email protected]

Let's Talk Revenue