LAKE OCONEE ORTHOPEDICS
Help Protect Access to Medicare Care
Lake Oconee Orthopedics is asking for your help regarding a proposed Medicare payment policy that could affect how and when Medicare patients receive care.
8 days left to comment — the CMS public comment period closes September 14, 2026
Dear Patients and Community Members,
Lake Oconee Orthopedics is asking for your help regarding a proposed Medicare payment policy that could affect how and when Medicare patients receive care.
The Centers for Medicare & Medicaid Services (CMS) has proposed a policy that would reduce payment by 50% for certain services provided during the same visit. Specifically, the proposal affects situations in which a physician performs a procedure and also provides a separately identifiable evaluation and management (E/M) service on the same day.
Why Does This Matter to Patients?
Many orthopedic visits involve more than one medically necessary service.
For example, a patient may come to our office with a new or worsening problem that requires a physician evaluation and, after that evaluation, also require an injection, treatment, or other procedure.
Today, these services can often be appropriately provided during the same appointment.
Under the proposed Medicare policy, practices could face a significant payment reduction when providing this care together. We are concerned that this policy could make it increasingly difficult for healthcare providers to continue delivering multiple necessary services during one visit.
For patients, this could mean:
More appointments to receive care that could otherwise be provided during one visit
Additional travel and transportation burdens
More time away from work, family, or other responsibilities
Delays in receiving treatment
Reduced access to physicians and healthcare services, particularly in smaller and rural communities
Why Lake Oconee Orthopedics Is Concerned
CMS has indicated that the proposed reduction is intended to address possible duplication when services are performed on the same day. However, physician organizations have raised concerns that a uniform 50% reduction does not adequately recognize that a separately reported E/M service must represent distinct, medically necessary work beyond the procedure itself.
A substantially similar proposal was considered by CMS in 2019 but was not finalized. The current proposal is broader and would apply to procedures with 0-, 10-, and 90-day global periods.
Lake Oconee Orthopedics joins physicians and medical organizations, including the American Medical Association, in urging CMS not to finalize this proposed 50% payment reduction.
What You Can Do
Contact Your Members of Congress
We encourage Medicare patients, family members, caregivers, and members of our community to contact their U.S. Senators and Representative.
Ask them to urge CMS to withdraw the proposed 50% payment reduction for separately identifiable E/M services reported with modifier -25.
Tell them that Medicare policies should support patients receiving appropriate, efficient care during a single visit whenever medically appropriate, rather than creating incentives for care to be divided among multiple appointments.
Submit a Public Comment Directly to CMS
CMS is accepting public comments on the proposed 2027 Medicare Physician Fee Schedule through September 14, 2026.
View the proposed rule and submit your comment here:
View the rule & commentWe Encourage You to Do Both
Contact your members of Congress AND submit a comment directly to CMS.
This issue is about more than physician reimbursement. It is about preserving timely, efficient access to care for Medicare patients in our community.
Your voice matters. We encourage you to act before the September 14, 2026 public comment deadline.
Thank you for helping us advocate for continued access to high-quality Medicare care in our community.
Lake Oconee Orthopedics