A note to our patients
What is being proposed, why it matters for independent practices like ours, and how you can help.
You may have seen our notice in the office. We want to give you the fuller picture here, in plain terms, so you can decide for yourself whether it is worth acting on.
Each year, Medicare sets how much it pays physicians. For 2027, it has proposed changes that go well beyond the usual yearly adjustment — and they come on top of an automatic cut already scheduled for 2027 and years of cuts before it. This is not a single trim. It is one more reduction stacked on many.
One of the changes would cut payment by half when a physician provides an office visit and a procedure on the same day — which, in ear, nose, and throat care, is most visits. A scope, a cleaning, a biopsy alongside your exam is how we care for you efficiently in one trip.
These are still proposals. They are not final. Medicare is taking public comment through September, and a final decision comes later this year. A very similar proposal was withdrawn once before, in 2019, after doctors and patients spoke up.
Because the cut only applies when the visit and the procedure happen on the same day, it pushes practices toward an absurd workaround: splitting one visit into two — the procedure on one day, the office visit on another — simply to avoid the penalty.
For you, that means two trips instead of one, for care that should take a single appointment. For the large hospital systems, it means something else entirely: a second facility fee. The rule quietly rewards the very setting that already costs you more, and penalizes the efficient, one-visit care that independent practices are built to provide.
Here is the part that is easy to miss. By law, large hospital systems receive an automatic raise each year to keep up with inflation. Independent physicians receive no such increase. We are left to divide a fixed pool of money that does not grow — even as our costs for staff, supplies, and rent rise every year.
At the same time, the big hospital systems add a separate facility fee to your bill for the same care you can receive in our office without one. When Treasure Coast patients objected to those fees, the chief medical officer of Cleveland Clinic’s Martin North and South Hospitals defended them. As NBC News reported, he told patients:
(that) they were now receiving “hospital-level care” that independent doctors don’t offer.
— NBC News, “After Cleveland Clinic expanded to Florida, patients say surprise fees followed,” July 2025
We will let you be the judge of that. What we know is this: you can receive expert, specialized care right here, without a hospital facility fee attached. These proposed cuts would only push more care into that higher-cost hospital setting — the opposite of what most patients want.
It is easy to assume that when Medicare pays for your visit, that money simply goes into the doctor’s pocket. It does not. That payment has to run an entire practice — the medical assistants who room you, the clinical staff who care for you, the team that answers your calls, refills your prescriptions, and fights to get your prior authorizations approved, along with the rent, the equipment, the supplies, malpractice coverage, and the technology that keeps your records safe.
Since 2020, the cost of nearly all of it has risen sharply. Staff wages, supplies, rent, insurance — everything it takes to keep our doors open costs significantly more than it did a few years ago. Yet Medicare’s payment for your care has not kept up; in fact, it keeps getting cut. A practice cannot absorb rising costs and falling payments forever.
Independent practices across the country are already limiting how many Medicare patients they can see, or being bought up by larger corporations. Today, more than eight in ten physicians are employed by a large system rather than practicing independently. Cuts like these accelerate that shift. Fewer independent doctors means less choice, longer waits, and often higher costs for the same care.
We intend to keep practicing the way we always have — and we are asking for your help to protect that.
This is still only a proposal, and proposals can be stopped. Your voice as a patient carries more weight than ours ever could. Here is how to use it.
1. Call or write your representatives
Rep. Brian Mast • Stuart office (772) 403-0900
Sen. Rick Scott • (202) 224-5274
Sen. Ashley Moody • (202) 224-3041
2. Not sure what to say? Use this.
“Hello, my name is ______ and I am a constituent and a patient. I’m calling to ask the Congressman to protect independent physician practices from the Medicare payment cuts proposed for 2027. My independent doctor provides care I depend on, and these cuts threaten it. Please oppose the same-day payment reduction and support fair Medicare payment for independent physicians. Thank you.”
You don’t have to use these exact words — speaking from your own experience is even better. Leave a voicemail if no one answers; every call is counted.
3. Or comment to Medicare directly
You can also submit a comment to Medicare on the proposed rule through September 14, 2026, at regulations.gov (docket CMS-2026-2377).
Thank you for standing with us. We are not going anywhere without a fight — and with you beside us, we intend to win it. — The physicians and staff of Independence Ear, Nose & Throat
This page is provided for information by Independence Ear, Nose & Throat. The changes described are part of the proposed Calendar Year 2027 Medicare Physician Fee Schedule, open for public comment through September 2026.