Medicare proposes cuts to specialty physician payments

The proposal would benefit primary care doctors while cutting how much Medicare pays for many tests and scans.

Medicare plans pay cuts for specialty physicians in new rule

Medicare has announced plans for cuts affecting specialty physicians in its proposed 2026 rule aimed at adjusting payments across thousands of procedures. This decision targets what Medicare describes as overpriced medical services. More than half of the billing codes, essential to physician payments, have not been updated in over 30 years. The agency plans to eliminate reliance on surveys that have shown low response rates, which it claims distort pricing for various services. This shift intends to provide better balance between primary care physicians and specialists.

The proposed cuts could reshape the healthcare landscape by encouraging a focus on primary care. Critics argue that the current payment system has favored specialists, leading to disparities in healthcare access. By reevaluating payment rates, Medicare could potentially promote a more equitable system. However, these cuts may provoke backlash from specialty physicians who argue that their training and expertise justify higher payments. The long-term implications for patient care and provider behavior hang precariously in the balance.

Highlights

The future of physician payments is uncertain as this proposal moves forward.