2025 MPFS Updates and Their Effect on Pathology Billing

The proposed 2025 Medicare Physician Fee Schedule (MPFS) introduces significant changes that impact pathology billing, continuing a trend of declining reimbursement rates. Pathology practices face a projected 2.4% reduction in payments compared to 2024, culminating in a cumulative 7% decrease since 2021. This reduction stems from the expiration of temporary relief measures and a lower conversion factor. The new schedule also includes adjustments to the Quality Payment Program (QPP) and the introduction of additional CPT codes. This blog systematically examines these changes and their implications, providing strategies for adaptation.