Physician fee schedule: CMS confirms fee cuts, expands behavioral health services in final 2025 PFS

Why This Topic Matters

The final rule affects reimbursement, reporting, and supervision policies across multiple Medicare payment and quality programs. Practices that bill under Medicare Part B, manage behavioral health or therapy services, or handle global surgical and compliance workflows may need to update internal processes for 2025.

Article Sections

1. Payment updates and conversion factors

   Summarizes the final Medicare physician fee schedule payment changes for 2025, including the conversion factor and anesthesia conversion factor updates.

2. Plane blocks and anesthesia policy

   Covers new anesthesia-related coverage and coding updates, including changes affecting plane blocks and base units.

3. Digital mental health treatment services

   Reviews new behavioral health-adjacent HCPCS services for digital mental health treatment and related reporting considerations.

4. Interprofessional consults for mental health

   Describes the new Medicare coverage for mental health interprofessional consultation services and the general policy framework for those services.

5. Safety planning, assessment, follow-up

   Covers new and revised behavioral health service policies related to safety planning and post-discharge follow-up care.

6. Complexity of care add-on expansion approved

   Explains changes to reporting policy for a complexity-of-care add-on code when billed with certain office and outpatient services.

7. Virtual check-in and telehealth policy

   Discusses the transition from an older virtual communication service to a newer CPT code and the continuation of selected telehealth flexibilities.

8. Modifier updates for global surgical packages

   Summarizes final policy on transfer-of-care modifiers and related add-on payment provisions tied to surgical global periods.

9. New overpayments rules

   Reviews changes to Medicare overpayment standards and timelines for Parts A, B, C, and D, including related compliance implications.

10. QPP: MVP in mind, but no date

    Covers Quality Payment Program and MIPS updates, including pathway expansion, measure structure, and performance threshold policies.

11. Shared Savings goes 'prepaid' for some groups

    Summarizes MSSP-related changes, including a new prepaid savings option, benchmark adjustment policy, and participation conditions.

12. General supervision for therapy assistants

    Describes changes to outpatient therapy supervision, plan-of-care documentation, and therapy threshold policies.