The Centers for Medicare and Medicaid Services (CMS) released proposed rules for 2027 on the Medicare Physician Fee Schedule (MPFS) and the Hospital Outpatient Prospective Payment System (HOPPS).  Changes in policy and payment made by the rules become effective on January 1, 2027.

The MPFS proposed rule for 2027 will result in reductions in payment of 2 – 4 percent for most epilepsy center services due to the proposed reductions in the conversion factors and changes in the methodology for calculating practice expense values. The rule recognizes the extension of the telehealth flexibilities first allowed during the COVID-19 pandemic by Congress, which will remain in effect until December 31, 2027.  A high level summary of the rule along with the charts for epilepsy services can be found here.

NAEC has prepared a chart showing the impact of the HOPPS rule on neurology/epilepsy outpatient services.  CMS is proposing a 2.4% inflationary increase for hospital outpatient facility costs. Medicare reimbursement for the facility costs of most neurophysiology services provided in the outpatient setting are increasing by 11 – 14 percent.

Please reach out to NAEC at info@naec-epilepsy.org with any questions.