American Podiatric Medical Association opposes CMS policy on same-day service billing

The Centers for Medicare and Medicaid Services (CMS) has finalized a policy that reduces reimbursement for certain outpatient services provided on the same day as a medical evaluation. Beginning January 1, 2027, the rule applies to billing practices where an evaluation and management visit is combined with a 0-day global procedure by the same provider.

The American Podiatric Medical Association (APMA) has formally denounced the policy, arguing that it creates significant barriers to patient access. While the final rule represents a lower reduction than the initially proposed 50% cut, the association maintains that the 20% reduction will disproportionately impact podiatrists, who frequently address multiple health concerns in a single visit, including critical diabetic foot complications.

Industry experts suggest that the policy could exacerbate financial instability for solo and rural practitioners, potentially leading to clinic closures or industry consolidation. APMA President Patrick DeHeer characterized the decision as a threat to essential care, noting that reduced financial incentives may lead to delayed treatments for seniors and underserved populations.

APMA continues to advocate through the Same Day Care Coalition to urge Congress to block the implementation of the rule, citing concerns over long-term patient health outcomes and workforce sustainability.