Modernizing The Medicare Physician Fee Schedule: Non-Paid Activities Call For Hybrid Payment For Primary Care

Health Affairs November 24, 2025
Laura Skopec, Robert A. Berenson

Editor’s Note

This is part one of a two-part article on policy issues in the Medicare Physician Fee Schedule. Part two, ”Modernizing The Medicare Physician Fee Schedule: Creating a Separate Conversion Factor for Primary Care,” will appear tomorrow.

Nearly all physicians perform tasks that are not directly billed as patient services. The National Academies of Science, Engineering, and Medicine (NASEM) has identified an extensive list of non-visit components of high-value primary care, including care coordination, case management, patient navigation, data analytics, outreach and engagement, referral management, documentation, inbox management, phone calls and messaging, remote monitoring, prior authorization, formulary coordination, and managing long-term care services. As part of a project assessing the Medicare Physician Fee Schedule (MPFS), we reviewed the literature...

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