November 6, 2026
Final Rule: 2027 Medicare Physician Fee SchedulesÂ
2027 Medicare Physician Fee Schedule Impact TableÂ
Transcript
Nick Lanyi
A big win on surgical pathology codes. It's that time again to check your MIPS scores and a look at the critical shortage of forensic pathologists. These stories and more coming up next. Welcome to CAP News. I'm Nick Lanyi with the College of American Pathologists. It's Friday, November 6th. Here's what's making news in pathology and laboratory medicine. In a major win for pathologists, surgical pathology codes will remain unchanged in the final 2027 Medicare Physician fee schedule released yesterday by the Centers for Medicare and Medicaid Services. The proposed changes would have cut payment for some surgical pathology services by up to 90%. The CAP launched an advocacy campaign opposing the changes that included extensive formal comments, a grassroots letter writing campaign, and winning bipartisan congressional support. In its final rule, CMS said that after considering the public comments, it is neither re-valuing the codes nor finalizing any changes at this time. But surgical pathology codes could face changes down the road. Despite this important victory, Medicare reimbursements to pathologists are expected to fall by 2.3% in 2027 due to changes in the 2027 fee schedule and the expiration of payment relief under the 2025 One Big Beautiful Bill Act. For details, see the CAP's impact table on the CAP website and in the show notes. CMS also released its final scores under the 2025 Merit-Based Incentive Payment System, or MIPS. These scores will determine Medicare payment adjustments in 2027 for practices that participate in CMS's Pathologist's Quality Registry. MIPS is a performance-based alternative to the regular Medicare rate system. Payments are based on the MIPS score, which measures quality of care and other factors. The CAP urges practices that participate in the Pathologist Quality Registry to review their final scores and payment adjustment information as soon as possible. If you believe CMS incorrectly calculated your final score or payment adjustment, you can request a targeted review through November 30th at 8 p.m. Eastern. The American Medical Association released a proposed framework on liability for AI systems used in clinical settings. This is part of the rollout of a broader framework for handling the growing role of artificial intelligence in medicine. When it comes to liability, the AMA said physicians should be accountable for the clinical judgments they exercise, while AI developers should be accountable for the systems they build and the risks they can control. Meanwhile, hospitals and other healthcare organizations that set up AI systems should be accountable for where and how the technology is put to work. The AMA framework said patients should have ways to seek accountability and appropriate remedies when harm occurs. And finally, the workforce shortage in pathology and laboratory medicine is especially acute among forensic pathologists. One estimate found that the U.S. needs to double its number of forensic pathologists to adequately cover the need. Dr. Tanner Bartholow is an associate professor of pathology and director of adult autopsy services at the University of Pittsburgh School of Medicine and a member of the CAP Autopsy Committee. He calls the problem critical and getting worse.
Dr. Tanner Bartholow
A shortage can lead to a worse shortage. Because if you have a shortage of individuals involved in a field, that means more work for each individual person in that field. When that workload exceeds a certain point, then those people might move on, and then that creates a shortage. And then when there's a shortage of people to do the work, there's also a shortage of people to teach and mentor, which then creates a lack of opportunities for new people to get arrested in the field. And then if you have enough shortages, well then can you have like a training program? And etc. What we want to avoid is basically ticking off all the boxes of all the possible types of lab tests that could present in a patient with slightly abnormal bleeding factors and or a suspected bleeding history. So the cycle sort of feeds itself.
Nick Lanyi
The problem, he said, is that many medical schools don't expose students to forensics, and pathology rotations don't emphasize autopsy work. In addition, salaries in the field tend to be lower than those of other specialties. Dr. Bartholow said the solution is for forensic pathologists to connect with students and trainees.
Dr. Tanner Bartholow
It's my job to show up every day and try to give people the best educational experience and to provide the best care we can for our decedents and their families, and hopefully through that showing residents, you know, med students and trainees, that this is a great career path. It's very rewarding. It's a little bit different than the rest of pathology, but for the right person where their interest is sparked, and um they see a whole career unfold in front end.
Nick Lanyi
Emerging technologies, including AI, could help forensic pathologists get more done in less time. But Dr. Bartholow said human interaction can't be replaced. After all, a forensic pathologist is often the doctor who explains why families just lost a loved one.
Dr. Tanner Bartholow
Being able to help to whatever extent we can provide to family closure, to answer their questions, etc., really is one of the most rewarding things because you're, you're a person doing that. You're a person putting all your effort into helping someone find answers, helping someone find closure. And and I feel like that that would be something that would be very hard to take the the personal connection out of.
Nick Lanyi
That's all for today. See the show notes for more information on today's stories, and spread the word about this podcast by sharing a link on social media. We'll be back Monday, November 9th with another edition of CAP News. I'm Nick Lanyi. Have a wonderful weekend.