Key Facts

• CMS finalized Medicare physician payment changes for 2027 in early November.
• The policy concerns certain cases in which a separately identifiable office or outpatient evaluation occurs on the same day as a procedure.
• The payment adjustment applies when the services are performed by the same physician or by physicians in the same practice.
• Under the described payment method, the highest-priced service receives full payment and other affected services receive 50 percent.
• CMS says the adjustment addresses possible overlap in resources and payment for work already covered by a procedure.
• A report highlighted by the National Institutes of Health estimated that cancer patients’ travel, waiting, and care time represented $4.87 billion nationally in 2019.
• A 2026 meta-analysis found that each additional 30-day wait before initial surgery for invasive breast cancer was associated with a 15 percent higher risk of death.
• The time-cost estimate and surgery-delay finding do not establish that the Medicare payment changes will cause comparable effects.