On November 1, 2024, the Centers for Medicare and Medicaid Services (CMS) released its Calendar Year (CY) 2025 Medicare Physician Fee Schedule (PFS) and the Quality Payment Program (QPP) final rule. CMS finalized significant cuts to the Anesthesia Conversion Factor that will compound the financial strain that anesthesia groups are already facing. The final rule underscores how the Medicare payment system is broken and in dire need of reform. Since the summer, ASA and other medical specialties have been advocating for Congressional action to stop these cuts and for more comprehensive reforms to take place.
Fee Schedule Provisions:
The 2025 final Anesthesia Conversion Factor (CF) is $20.3178, representing a decrease of 2.20% from the 2024 Anesthesia CF of $20.7739. The 2025 final RBRVS CF is $32.3465. This represents a decrease of 2.83% from the 2024 CF of $33.2875. The change to the PFS conversion factors incorporate the 0.00 percent overall update adjustment factor required by statute, a relatively small estimated positive 0.05% budget neutrality adjustment necessary to account for changes in work relative value units (RVUs) for some services, and the expiration of the temporary 2.93% increase in payment for services furnished from March 9, 2024 through
December 31, 2024. The negative adjustments result in large part from a statutorily mandated budget neutrality adjustment to account for changes in work Relative Value Units (RVUs). This means spending in one year needs to be balanced by reductions. CMS cannot increase or decrease expenditures by more than $20 million without triggering automatic budget neutrality adjustments.
Final Conversion Factors:
|
2024 CF |
Final 2025 CF |
Percent Change |
Anesthesia |
$20.7739 |
$20.3178 |
-2.20% |
RBRVS |
$33.2875 |
$32.3465 |
-2.83% |
Specialty |
Allowed Charges (mil) |
Impact of work RVU Changes |
Impact of PE RVU Changes |
Impact of MP RVU Changes |
Combined Impact |
Anesthesiology |
$1,591 |
1% |
1% |
0% |
2% |
Nurse Anesthetist/ Anesthesiologist Assistant |
$1,056 |
0% |
1% |
0% |
1% |
Interventional Pain Management |
$839 |
0% |
0% |
0% |
0% |
Code |
Descriptor |
Finalized 2025 wRVU |
64466 |
Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed |
1.50 |
64467 |
Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed |
1.74 |
64468 |
Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed |
1.67 |
64469 |
Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed |
1.83 |
64473 |
Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed |
1.34 |
64474 |
Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed |
1.67 |
64486 |
Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed) |
1.20 |
64487 |
Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed) |
1.39 |
64488 |
Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed) |
1.40 |
64489 |
Transversus abdominis plane (TAP) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed) |
1.75 |
Date of last update: November 1, 2024