CMS has proposed changes that would cut same-day ENT reimbursements and restrict access for the patients who need us most. Your voice as a physician carries real weight. Here's how to use it.
Simple steps. Powerful impact.The proposed 2027 Medicare Physician Fee Schedule would directly impact how you deliver ENT and allergy care. Take action below — it takes less than 10 minutes.
CMS has released a proposed rule that would cut reimbursement for same-day evaluation and treatment — the fundamental workflow of ENT practice. Here's what you need to know.
CMS proposed nearly identical Modifier 25 cuts in the CY2019 Physician Fee Schedule. After a strong response from specialty societies during the public comment period, CMS withdrew the proposal entirely. Your comments directly contributed to that outcome. This year's comment deadline is September 14 — and the same opportunity exists right now.
| Specialty | Estimated CY2027 RVU Impact | Primary Driver |
|---|---|---|
| Otolaryngology (ENT) | Approx. −9% | Same-day E&M + in-office procedure |
| Dermatology | Approx. −9% | Same-day E&M + lesion procedure |
| Orthopedic Surgery | Approx. −7% | Same-day E&M + injection or casting |
| Hand Surgery | Approx. −5% | Same-day E&M + procedure |
| Clinical Psychology | Approx. +11% | Redistribution of RVUs |
| Clinical Social Work | Approx. +12% | Redistribution of RVUs |
Commercial payers have historically followed CMS on multiple procedure payment reductions and E&M downcoding — often adopting similar policies in their next contracting cycle. If this rule is finalized, commercial payers may implement equivalent edits as early as 2028. The full financial exposure for SENTA network physicians could be substantially larger than the Medicare-only figures above.
Send a personalized letter to your U.S. Representative and Senators urging them to oppose the proposed Modifier 25 payment cuts and reductions that threaten same-day ENT care.
CMS is accepting public comments through September 14, 2026. Personalized physician comments carry significant weight. Submit yours directly to the federal docket.
Amplify the message with colleagues, professional organizations, and on social media. The more physician voices speaking up, the harder it is for CMS to ignore.
Share on LinkedInReal clinical examples are the most powerful advocacy tool we have. If you have a patient case that shows what these cuts would mean in practice, we want to hear it.
Compelling advocacy starts with real experiences. If you have a patient case or practice example that illustrates what these proposed payment changes would actually mean — on access, timing, and outcomes — your story may help inform our outreach to CMS, legislators, and coalition partners.
Send Your Story to SENTA