The Centers for Medicare & Medicaid Services (CMS) is seeking public comment on whether the surgical pathology code family is potentially misvalued as part of the proposed 2027 Medicare Physician Fee Schedule.
What to know:
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The agency’s request is based on an analysis conducted by the Maryland Health Care Commission (MHCC) that the College of American Pathologists (CAP) believes overlooks important pathology-specific coding, billing attribution, and data quality issues and does not accurately reflect pathology practice or resource utilization.
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The CAP is urging pathologists to ask CMS not to make changes to surgical pathology services in 2027 based solely on the MHCC analysis. Instead, the CAP recommends that any future review follow the established valuation process, include a comprehensive assessment of physician work and practice expense, and rely on robust clinical and comparative data.
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Unwarranted payment reductions could threaten patient access to timely, accurate, and high-quality pathology diagnoses, potentially affecting treatment decisions and patient outcomes.
The bottom line: Federal agencies carefully consider public comments during the rulemaking process, particularly those submitted by physicians and other health care professionals with firsthand experience.
Take action: Submit your comment to CMS by 11:59 PM ET on September 14 and help ensure pathology’s voice is heard.