2025 Big Updates on Medicare Reimbursement and Payment System: Impacts and Compliance

Course Description:

The Medicare Physician Fee Schedule (PFS) is a key component of the Medicare payment system. It sets the rates for services provided by physicians and other healthcare professionals under Medicare Part B. Established by the Centers for Medicare & Medicaid Services (CMS), the PFS is updated annually and outlines how healthcare providers are reimbursed for services, including office visits, surgical procedures and diagnostic tests. Each year, CMS publishes a proposed rule for the next year’s PFS, outlining any changes in reimbursement rates, coding updates and new or revised regulations. Stakeholders, including healthcare providers and advocacy groups, have the opportunity to comment on these proposals before they are finalized. The final rule is typically released in the fall, with changes going into effect on January 1 of the following year.

In recent years, updates to the PFS have focused on shifting towards value-based care, promoting telehealth services and addressing disparities in reimbursement across different types of providers and services. Understanding the Medicare Physician Fee Schedule is essential for healthcare providers, as it directly impacts revenue cycles, practice operations and patient care delivery. The PFS plays an important role in ensuring that physicians and healthcare providers receive fair compensation for the care they provide while helping to control Medicare spending. It impacts millions of healthcare providers and influences how physicians manage their practices, allocate resources and deliver care.

For patients, the PFS can affect the availability and accessibility of services, as providers may adjust their practices based on reimbursement rates. Get ahead of the curve with expert insights on the Centers for Medicare & Medicaid Services (CMS) proposed rule for 2025. In this webinar, we will break down the complex regulations, payment model changes and compliance requirements that could significantly impact healthcare providers, payers and patients.

Learn about the latest regulatory updates, proposed changes to reimbursement models and how these updates are expected to reshape the current healthcare landscape. Gain a clear understanding of the provisions impacting Medicare Part A and Part B services, as well as changes to Medicare Advantage (Part C) and prescription drug plans (Part D). The webinar will cover proposed adjustments to the Medicare PFS, focusing on shifts in Relative Value Units (RVUs), the conversion factor, and how these changes could impact provider reimbursement and practice sustainability. Although the rule is still in the proposal stage, preparing your organization now is critical. We will outline steps you can take to stay proactive, including setting up systems for ongoing monitoring and training to ensure seamless compliance when the final rule is enacted.

Learning Objectives:

A deep dive into the CMS Rules for 2025: what it covers, what’s new, and how it will affect the healthcare landscape
Learn the Latest regulatory updates and changes to reimbursement models and its impact on physicians and practice’s revenue
Discuss finalized proposals
Changes in payment structures, including value-based payment models and how they influence provider reimbursement
Preparing for the administrative and operational shifts that may accompany the new rule
How the proposed changes aim to improve patient care outcomes and reduce healthcare costs

Areas Covered in the Session:

CY 2025 PFS Rate Setting and Conversion Factor
Improving Ambulatory Specialty Care
Caregiver Training Services (CTS)
Visit complexity add-on code G2211
Updates to Medicare Part D Drug Coverage: elimination of the “donut hole”, required payment plans and $2,000 out of pocket max
Advanced Primary Care Management Services (APCM)
Cardiovascular Risk Assessment and Management
Strategies for Improving Global Surgery Payment Accuracy
Behavioral Health Services
Other proposals
Live Q&A Session

Suggested Attendees:

Healthcare Administrators
Physicians
Practice Owners
Non-Physician Practitioners
Medical Office Managers
Billers and Coders
Medical Assistants
Nurses
Agency Owners
Clinical Supervisors
Directors of Nursing
Quality Improvement/ Quality Assurance Managers
Compliance Officers
Clinicians
Administrative Staff
Out-of-Network Providers
C-level Executives
Office Managers and Staff
Billing Managers
Medical Billing Companies
Insurance Companies
Hospital Revenue Cycle Staff
Credentialing Staff
Medical Providers who are Involved in the Payment Process of their Practice
Financial Officers and Healthcare Policy Professionals

About the Presenter:

Jan Hailey, MHL, CMC, CMCO, CMIS, CMOM, CMCA-E/M, has more than 30 years of experience in healthcare. She is proficient in administration, coding, and billing roles, and teaches medical office professionals around the country how to excel in their careers. Jan's affinity for teaching has helped countless healthcare providers and medical office professionals over the years. During her expansive career, she has led comprehensive interdisciplinary teams working closely with providers, management, staff, communities, and payers to develop strategies for process improvement, quality gap closures, and patient experience.

Jan has a Master of Health Leadership degree and five professional certifications in office management, coding, insurance processing, auditing, and compliance. She is a WPS Government Health Administrators (Medicare) Provider Outreach and Advisory Group member and has also been instrumental in Workforce Development Initiatives.

Additional Information:

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly

Can’t Listen Live?

No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com

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