The following is from the American Medical Association. 

On Friday, May 9, the American Medical Association (AMA) submitted a letter to the Centers for Medicare and Medicaid Services (CMS) asking the agency to adjust the 2026 Medicare conversion factor upward to account for the $1 billion difference between CMS' projected and actual utilization of G2211. Based on an analysis of the first three quarters of 2024 Medicare claims data, G2211 was reported with 10.5% of office visits, far below CMS’ projected utilization of 38% of all office visits.

If the trend continues in the fourth quarter, the AMA expects utilization to be 11.2%. As a result, the 2024 budget neutrality adjustment when CMS began paying for G2211 was nearly three times as large as it should have been. Specifically, the budget neutrality adjustment in the 2024 final rule resulted in a 2.18% decline, but the actual 2024 claims data suggest this should have been a 0.79% decline. Thus, the Medicare physician payment schedule was incorrectly reduced by about $1 billion in 2024, and this shortfall will continue indefinitely unless the Trump Administration steps in to fix it.

Read the full letter here.