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CMS's proposed 2027 Medicare Physician Fee Schedule would reimburse only 50% of a second same-day service, squeezing dermatology practices financially. Dermatologists warn the real-world impact far exceeds CMS's estimated 9% reduction in allowed charges. Rural clinics and Medicare-heavy practices could face staffing cuts, fewer appointments, and delayed skin cancer diagnoses.
CMS's proposed 2027 Medicare Physician Fee Schedule includes a billing change that could hit dermatology practices hard. Under the new rule, when a physician performs both an office visit and a same-day procedure — like a biopsy — Medicare would pay 100% of the higher-priced service but only 50% of the other, even if both are medically necessary. Dermatologists say this undermines the very care model that catches skin cancer early.
Betsy Wernli, MD, president of Forefront Dermatology — which operates over 300 clinics, 156 of them in rural communities — warns the financial pressure could force practices to cut staff, reduce appointment slots, and shorten clinic hours. For patients, that translates to longer waits and farther travel, with potentially life-altering consequences for those with suspicious lesions.
Key Takeaways:
Why it matters: Early detection is dermatology's most powerful tool against skin cancer. Payment cuts that reduce clinic capacity don't just affect practice revenue — they delay diagnoses, drive up downstream treatment costs, and put vulnerable patients at risk.
