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14th Jul, 2026 12:00 AM
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CMS Proposes Major Medicare Physician Payment Overhaul to Boost Primary Care

July 14 (Reuters) - The Centers for Medicare & Medicaid Services on Tuesday proposed changes to Medicare's decades-old physician payment system, saying the ⁠updates would support the Trump administration's push to emphasize primary and preventive care rather than treatment after patients become ⁠ill.

Here are some details:

• The proposal would update Medicare's Physician Fee Schedule, which is used to ⁠pay doctors and other clinicians ‌for services provided to beneficiaries.

• CMS said the changes are intended to make payments more accurate by accounting for the time, resources and complexity involved in care.

• CMS also said it wants to increase transparency around how physician payment rates are calculated and strengthen ‌oversight of billing practices in cases where claims may not accurately reflect ​services provided.

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• ‌The agency said the changes would ‌move Medicare away from paying mainly for the volume of services and toward rewarding better outcomes for patients.

• "We're ⁠proposing some of the most significant Medicare reforms ‌in recent years to strengthen ⁠primary care, expand accountable care, ​and modernize physician payment," CMS Administrator ‌Dr. Mehmet Oz said in the announcement.

• The proposed physician payment changes are designed to support primary care, preventive services and better coordination for people covered by Medicare, CMS ​said.

• CMS said it would end traditional Merit-based Incentive ‌Payment ‌System (MIPS) reporting in 2029 and move clinicians toward more specialty-focused reporting pathways.

• The agency also ‌proposed new reporting options ​for doctors who treat diabetes, high blood pressure and hospital patients,

• The change would stop $2.38 billion in bonus payments from going to clinicians who are ⁠not in advanced value-based care programs, the agency said.

• The proposal ‌is open for public comment before CMS issues a final rule.

(Reporting by Padmanabhan ​Ananthan in Bengaluru; Editing by Tasim Zahid)


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