ENT Specialists Warn of Medicare Access Crisis Under Proposed Cuts

The survey of 1,406 otolaryngologists reveals that financial strain is pushing many practices to a breaking point. More than two-thirds of respondents indicated they would be forced to limit the number of Medicare patients they accept, while 14% stated they may stop participating in the program entirely if the 2027 Medicare Physician Fee Schedule is finalized. The proposal specifically targets Modifier -25, which currently allows physicians to be compensated for providing a separate medical evaluation and procedure during a single visit. Under the new rule, CMS would cut payment for the second service by 50%.

Rahul K. Shah, MD, MBA, CEO of the AAO-HNS, argues that the math behind these cuts fails to reflect the reality of clinical practice. Physicians contend that performing these services on the same day is an efficiency for patients—avoiding multiple trips for urgent concerns like head or neck cancer screenings—rather than a duplicate payment. Beyond the immediate impact on patient volume, 82% of surveyed doctors expect the policy to delay care in ways that directly diminish quality of life. As the public comment period remains open until September 14, a coalition of nearly 20 organizations is urging the agency to reconsider the cuts, warning that rural and underserved areas will suffer the most significant consequences.