CMS Releases 2025 Medicare Physician Fee Schedule Proposed Rule

On July 10, the Centers for Medicare & Medicaid Services (CMS) released the 2025 Medicare Physician Fee Schedule (PFS) proposed rule, which determines payment for services to health care and mental health providers, including mental health counselors, who serve Medicare beneficiaries. The payment program has been in place since 1992 and is updated annually.

Calendar Year 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies

The 2025 PFS rule includes changes to payment rates, provisions to expand access to behavioral health care services including older adults at high risk of suicide, additional payments for treatment for opioid overdoses, and plans for maintaining telehealth flexibilities.

NBCC will provide official comments this summer to CMS on key behavioral health provisions contained in the 2025 PFS rule.

In addition to the release of the PFS proposed rule, CMS released a proposed rule that will update the Medicare Hospital Outpatient Prospective Payment System (OPPS) for 2025.

Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems

Provisions contained in the OPPS proposed rule also include new efforts to further reduce opioid overdoses and ensure effective pain management.

NBCC will provide separate comments on the OPPS rule as well.

For more information on NBCC’s Medicare advocacy, educational initiatives, and previous NBCC comments on the 2024 Medicare PFS and OPPS rules, please visit our Government Affairs Newsroom.