APMA is profoundly disappointed by the decision by CMS to move forward with a 20-percent reduction in payment for certain services reported on the same day with Modifier 25. The arbitrary cut, which was included in the Medicare Physician Fee Schedule final rule released on November 4, will harm physician practices and restrict patient access to needed care.

Thanks to APMA’s tireless advocacy, CMS mitigated its original proposal of a 50-percent cut. Any cut, however, will have a detrimental impact on physicians and patients nationwide.

Source: APMA

The Centers for Medicare and Medicaid Services (CMS) recently finalized the Calendar Year (CY) 2027 Medicare Physician Fee Schedule, which included an arbitrary 20 percent cut for services reported on the same day with Modifier 25. The proposal contradicts longstanding National Correct Coding Initiative (NCCI) and CPT® policies, undermines appropriate payment for separately identifiable evaluation and management (E/M) services, and threatens practice sustainability and patient access.  

Modifier 25 increases patient access to care by enabling physicians to manage multiple conditions in a single patient visit. This flexibility is particularly important for podiatrists, as their patients often present with multiple, unrelated foot conditions at the same time.   

Source: APMA

If you have had issues with DME enrollment this story may explain some of the reasons. This violation resulted in a $19M recoupment, and both defendants face significant jail time.

The supplier community has applauded the prosecution of these defendants but continues to wonder why it takes so long to catch up on these activities? And, why is the ethical provider (likely you, reading this) forced to face such a difficult time enrolling or re-validating their enrollments?

—Paul Kesselman, DPM

Have you experienced these sort of enrollment and re-validation issues? Let us know.

We are pleased to announce that Robert J. Snyder, DPM, MSc, MBA, CWSP, FFPM RCPS(Glasg), is the new editor-in-chief of Podiatry Management.

"I'm honored to lead Podiatry Management at such a pivotal time for our profession," Dr. Snyder says. "My goal is to make it the best-in-class publication in foot and ankle medicine." Readers of Podiatry Management and PM Pulse will soon begin to see new additions to our content lineup.

Diabetic foot ulcers (DFU) are not cured; they are driven into remission. Remission is a temporary state that can potentially end with a single unfortunate step. Clinically, we must collaborate with our patients to provide a safer daily environment for their feet. Such an environment alleviates ulcer risk factors such as changes in pressure, friction, and skin temperature. A multimodal approach with active clinical monitoring and patient adherence can generate improved outcomes such as reduced ulcer recurrence, infection, and amputations. This requires teamwork between the podiatrist and the patient. In this relationship, the podiatrist provides evidence-based information and care to the patient and helps the patient incorporate these evidence-based decisions into their daily lives

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