With MPFS proposal on the way, electrophysiology groups outline their priorities
The Heart Rhythm Society (HRS) and its new advocacy arm, Heart Rhythm Advocates (HRA), expect the Centers for Medicare and Medicaid Services (CMS) Calendar Year 2026 Medicare Physician Fee Schedule (MPFS) proposed rule to be announced in the days ahead.
As they wait for the MPFS proposed rule to drop, HRS and HRA have shared their three biggest advocacy priorities:
• Inclusion of ambulatory surgery centers for ablation procedures.
• Revaluation of the reimbursement code for left atrial appendage closure (LAAC)
• Revaluation of CPT Code 93296 for Remote Monitoring
These have all been major concerns for electrophysiology (EP) groups for several years now.
The groups said they will provide a detailed update to members after reviewing the proposal. They also are prepared to engage with CMS during the public comment period as needed.
HRS and HRA said the proposed rule, released each year in July, may significantly impact its members and patients' access to EP care in the United States. The groups plan to collaborate with other cardiology organizations on these are other cardiology policy issues. This includes active participation in the American Medical Association/Specialty Society RVS Update Committee (RUC), and coordinated legislative outreach through HRA.
HRS established HRA in 2024 to lobby for causes important to both electrophysiologists and the heart patients they treat on a daily basis. HRS felt compelled to create the group for greater EP advocacy after major Medicaid physician payment cuts cuts that HRS said are not sustainable.
HRA advocacy efforts so far in 2025
HRA is tracking legislation for site neutrality payments introduced in May by Senator John Kennedy (R-LA). The Same Care, Lower Cost Act (S.1629) aims to align Medicare fee-for-service payment rates across ambulatory settings starting in 2027. The bill directs the Secretary of the Department of Health and Human Services (HHS) to identify not fewer than 66 ambulatory payment classifications (APCs) for site neutral payments that are furnished in a hospital outpatient department, an ambulatory surgical center or other setting determined appropriate, HRA said in a statement.
The HHS secretary would also be able to add other APCs to those identified, as determined to be clinically appropriate. APCs for emergency department visits, critical care visits and trauma care visits in a hospital outpatient department will be reclassified as comprehensive APCs and all related items and services will be bundled into a single payment.
HRA is also supporting the Medicare Patient Access and Practice Stabilization Act of 2025 (S.1640) to increase reimbursement for physicians and other practitioners impacted by the 2.83% cut to the 2026 MPFS. The proposed legislation, introduced by Senator Roger Marshall, MD (R-KS), seeks to reverse the 2.83% cut in physician pay with an 8.51% increase for services furnished between June 1 to Dec. 31, 2025, and to address inflation and past reductions.
HRA is also extremely concerned by recent actions drastically reducing funding for National Institutes of Health (NIH)-supported research. HRS/HRA are proposing a three-part strategy in response that includes developing short-term fiscal strategies to protect ongoing research, launching a public education campaign on the importance of cardiovascular research, and engaging Congress through outreach emphasizing the importance of NIH funding.
The Trump administration directed the NIH in February to cut funding for extramural research by reducing the maximum indirect cost (IDC) rate to 15%. HRA said this is a devastating cut since IDC rates are typically over 50% for many medical centers and universities.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]