Most people don't follow healthcare policy. But this one is worth your attention, and the window to do something about it closes September 14th.
A new CMS proposal, if passed, would cut reimbursement by 50 percent any time a doctor performs a procedure on the same day as an office visit. On paper, it sounds like a billing technicality. In practice, it means that if your dermatologist finds a suspicious mole during a routine skin check, many practices would no longer be able to biopsy it that same day without losing money on the encounter. You'd be asked to come back. Two appointments, two copays, two weeks of waiting for answers about something your doctor told you looked concerning.
Dr. Dustin Portela and Austin Lee break down exactly how physician billing works, why the CMS framing of this as an "efficiency adjustment" misses the point, and what the real-world impact looks like across every specialty. This isn't a dermatology problem. It's a pediatrics problem, a cardiology problem, an ENT problem. Any doctor who currently handles two separate concerns in one visit would be forced to split them. For patients in rural areas who drive long distances to see a specialist, that's not a minor inconvenience. For practices already operating on thin margins after decades of declining reimbursements, it could mean staff cuts, dropped insurance plans, or closing altogether.
The good news: there is something you can do before the comment period closes. Contacting your two state senators and congressional representative directly, by phone or email, carries more weight than a CMS comment. Links to a sample letter and a tool to look up your representatives are in the show notes. If you add something personal, why this would affect your specific situation, it will land harder than a form letter.
Please share this episode. The more people who contact their representatives before September 14th, the better the outcome for patients.
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