The Centers for Medicare & Medicaid Services (CMS) will cut payment for some services billed alongside certain same-day procedures starting Jan. 1, 2027, drawing a warning from podiatrists about access to foot and ankle care.
The updated 2027 Medicare Physician Fee Schedule applies when an office or outpatient evaluation and management visit is billed with a procedure assigned a zero-day global period. Medicare will pay the highest-valued affected E/M visit or surgical service in full and pay the other affected same-day services at 80%.
The American Podiatric Medical Association (APMA) says the policy covers visits coded with modifier 25 if care is provided by the same physician or by physicians of the same specialty in one group practice.
CMS says the procedure rate already accounts for some of the clinical work involved, and the adjustment is intended to prevent what the agency considers a second payment for that work. Its initial proposal would have set the rate for other services at 50% and covered procedures with zero-, 10- and 90-day global periods. After public comments, CMS narrowed the change to zero-day procedures and raised the rate to 80%. The agency also says it considered a similar policy in 2019 but did not include it in that year's final fee schedule.
APMA says podiatrists may address several problems in one appointment, including diabetic foot ulcers. It warns that lower payment for additional qualifying services could strain solo, small and rural practices, and says the policy may make it harder for patients to receive care in one visit. The association also warned that delays for patients with diabetes could raise infection and amputation risks.
APMA President Patrick DeHeer, DPM, said rural and underserved communities could be particularly affected. “This policy threatens access to medically necessary same-day care,” he said. APMA has urged Congress to block the change before it takes effect.
The rule is scheduled for publication in the Federal Register on Monday, Nov. 9, and takes effect Jan. 1, 2027.
