One visit should mean one visit — not two co-pays and twice the hassle.

Independent physician practices like OrthoCincy are essential to patients in communities nationwide. But a new proposal from the Centers for Medicare & Medicaid Services (CMS) could make it significantly harder for practices to remain viable.

CMS is proposing cuts to Medicare payments by 50% for secondary medical services—usually the doctor’s office visit—when a patient receives a checkup and a minor, in-office procedure on the exact same day.

The Current System – One-Stop Care

Right now, if during your scheduled consultation visit something is found that needs immediate treatment (draining a cyst, injecting a painful joint, etc.) an in-office procedure can be performed right then and there. The clinic will bill Medicare for both the consultation visit and the procedure and gets paid fully for both.

• An orthopedic surgeon examines a knee and injects it.
• A pain management physician assesses a patient and performs a nerve block.
• A wound care specialist evaluates and debrides in the same visit.

2027 CMS Proposal

Under the proposed change, Medicare would pay 100% of the single highest-valued service done that day, but would slash the payment for any extra service (usually the consultation/visit code) by 50%.

What’s Next?

This could affect patient experience in several key ways.

• Delayed Treatment: If a doctor identifies an issue during a routine check-up (e.g., a suspicious mole or a swollen joint), the financial penalty will pressure clinics to schedule the treatment for a separate day.
• Increased Anxiety: Patients must wait days or weeks to get procedures like biopsies, lingering in a state of stress over potentially serious diagnoses.
• Prolonged Pain: Immediate therapeutic interventions, such as cortisone joint injections or draining an abscess, will be deferred, leaving patients in discomfort.
• Double Copays: Splitting a single-day event into two appointments forces patients to pay two separate office-visit copayments.
• Travel Expenses: Patients must pay twice for transportation, parking, or rideshare services to return to the clinic.
• Vulnerable Groups Hurt Most: Seniors with mobility challenges, low-income individuals and those living in healthcare deserts face steep hurdles arranging multiple medical trips.

Your Voice Matters

Let your government officials know the importance of preserving access to same-day care. Contact CMS and Congress and encourage them to oppose this proposal. Comments accepted through September 14, 2026.