CMS’ 2025 Medicare Physician Fee Schedule

CMS’ 2025 Medicare Physician Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) published the calendar year (CY) 2025 Medicare Physician Fee Schedule (MPFS). Providers will realize a 2.83% cut in reimbursement fees for 2025.  In addition, the 2% sequestration fee cut is still in place.  Congress did not take action to stop these cuts before adjourning for the year.  The Medicare Part B deductible for 2025 is $257.

The American Medical Association and the American Chiropractic Association have filed complaints with CMS, saying that inflation and rising overhead costs have burdened physicians. Historically, Congress has intervened at the beginning of the calendar year to lessen the looming cuts. We will keep you updated if Congress intervenes.

Due to the current uncertainty, we are recommending the following:

Participating Providers:  If you are a Medicare participating provider, we encourage you to continue to bill Medicare at your normal fees.  Your bills will be processed based on the appropriate fee schedule once released.

Non-Participating Providers: If you are NOT a Medicare participating provider, we recommend that you wait to submit your bills until we know if Congress will intervene. Based on current information, you may be able to process your claims for services after January 1, 2025, using the currently published 2025 rates and inform your patients that additional amounts may be owed or require refunding.

ZoneCodesParNon-ParLimiting Charge
Chicago (16) Cook County98940
98941
98942
$27.22
$39.33
$50.78
$25.86
$37.36
$48.24
$29.74
$42.96
$55.48
East St. Louis (12) BOND, CALHOUN, CLINTON, JERSEY, MACOUPIN, MADISON, MONROE, MONTGOMERY, RANDOLPH, ST. CLAIR AND WASHINGTON98940
98941
98942
$25.55
$37.04
$47.93
$24.27
$35.19
$45.53
$27.91
$40.47
$52.36
Suburban Chicago (15) DUPAGE, KANE, LAKE AND WILL98940
98941
98942
$27.35
$39.56
$51.10
$25.98
$37.58
$48.55
$29.88
$43.22
$55.83
Rest of State (99) All Other Counties98940
98941
98942
$25.23
$36.63
$47.44
$23.97
$34.80
$45.07
$27.57
$40.02
$51.83

About Author

Mario P. Fucinari DC, CPCO, CPPM, CIC

Dr. Mario Fucinari has helped train doctors and staff over the last 20 years. He received his bachelor's degree from Wayne State University in Detroit and his Doctor of Chiropractic degree from Palmer College of Chiropractic in 1986. Dr. Fucinari was the recipient of the 1998 and the 2003 President's Award from the Illinois Chiropractic Society (ICS) for his work with education and training and most recently received the 2012 Chiropractor of the Year award from the ICS. Dr. Fucinari was the first chiropractic physician to attain the Certified Medical Compliance degree. Two years later he earned his degree as a Certified Instructor for the Certified Medical Compliance Program. He is now the Chairman of the Chiropractic division of the national medical compliance program. He has produced classes and publications on HIPAA, Clinical Documentation, Medicare, and Stroke and Cervical Manipulation. He is a worldwide speaker for NCMIC, Foot Levelers, ChiroHealthUSA and several state associations and a Certified Chiropractic Sports Physician [CCSP]. Online CME Courses Connect

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