Advocacy & Practice Updates — Advocacy & Practice
The Fight Continues: ASRS, Coalitions Urge Administration to Drop Harmful Modifier -25 Proposal
ASRS members can join in the advocacy from home
ASRS is continuing its advocacy to prevent CMS from implementing a 2027 proposed 50% cut to the lesser value of services when an E/M visit is billed with Modifier -25 on the same day as a minor procedure. ASRS President Geoffrey G. Emerson, MD, PhD, FASRS again traveled to Washington, D.C. to meet with members of the White House’s Domestic Policy Council (DPC) to explain the harm this proposal would create in limiting beneficiary access to care and accelerating healthcare industry consolidation. In addition, Dr. Emerson represented ASRS at a meeting with key CMS leadership.
If CMS finalized this proposal, Dr. Emerson explained in both meetings, independent practice for many specialties like retina could become unsustainable because it would mean they would have to provide care below cost. Like the meeting with the Office of Management and Budget last week, the DPC plays an important role in ensuring agencies are implementing the Administration’s broader goals and can supersede CMS’ policy decisions.
ASRS also joined with the AMA and the entire medical community in a letter to CMS opposing the Modifier -25 proposal. The letter highlighted the potential financial threat to independent practices and reminded CMS that the AMA’s Relative Value Update Committee (RUC) already has policies to address the potential overlap in services when two codes are billed together frequently. While citing the potential that it was paying double for certain services when a Modifier -25 is used, CMS provided no evidence in the proposed rule to demonstrate it.
As ASRS and our coalition partners continue to advocate against this proposal, ASRS members can join the fight from home. Click below to send an instant, pre-written letter to Congress that asks your Representative and Senators to urge CMS not to finalize this policy.
Make your message even stronger by clicking the pencil icon and adding a description of how the cut would impact your practice and patients.
If you’d like to send a detailed comment letter to CMS, please contact Allison Madson, vice president of health policy, for assistance by September 11.
(Published 9.1.26)