
Final 2025 MPFS Cuts Pathology Rates by 2.5%
December 19, 2024The content of this article has been sourced from Volume 19, No. 12, December 2024 issue of Laboratory Economics, and is reprinted here with permission. Thank you to Laboratory Economics for granting us the right to share their valuable insights on this vital topic.
The Final Medicare Physician Fee Schedule (MPFS) for 2025 reduces professional rates paid to pathologists by an average of 2.5%, while technical fees paid to pathology labs will fall by approximately 2.7%. These cuts are primarily due to a 2.8% reduction in the final 2025 conversion factor to 32.3465. The rate cuts will become effective January 1, unless Congress intervenes with an end-of-year legislative fix.
The American Medical Association (AMA) and other physician groups are lobbying for the bipartisan Medicare Patient Access and Practice Stabilization Act of 2024 (HR 10073), which would stop the conversion factor cut and instead result in a 4.7% increase. However, barring last-minute legislative action, the following changes will become effective January 1, 2025.
Surgical Pathology
The global rate for CPT 88305 (Level IV, tissue exam) will drop by 2.8% to $69.54 in 2025; professional interpretation down 2.8% to $34.93; technical component also down 2.8% to $34.61.
The global rate for CPT 88307 (Level V, tissue exam) will decline by 3.3% to $278.18; professional interpretation down 2.8% to $76.66; technical down 3.4% to $201.52.
Immunohistochemistry
The global rate for CPT 88342 (IHC, first stain procedure) has been finalized to increase by 3% to $109.01; professional interpretation down 2.8% to $32.67; technical up 5.7% to $76.34.
The global rate for CPT 88341 (IHC, each additional stain) will rise by 3.2% to $93.48; professional interpretation down 1.6% to $26.52; technical up 5.3% to $66.96.
Special Stains
The global rate for CPT 88312 (Special stains, group 1) will decline by 3.7% to $108.36; professional interpretation down 2.8% to $24.91; technical down 3.9% to $83.45.
The global rate for CPT 88313 (Special stains, group 2) will decrease by 4% to $79.57; professional interpretation down 2.8% to $11.32; technical down 4.2% to $68.25.
Final Medicare Rate Changes for Key Pathology Codes for 2025
Source: Laboratory Economics from CMS