Advocacy Update Nov. 4, 2025
IN THIS ISSUE / Nov. 4, 2025
Medicare Physician Payment
ICYMI: Medicare finalizes slight payment increase for 2026
Dermatologists will see a slight payment increase for the first time in five years, according to the final 2026 Medicare Physician Fee Schedule (PFS) published on Oct. 31. While this is a step forward, other finalized policies may reduce physician payment in future years. Securing comprehensive Medicare payment reform with an annual, inflation-based update remains the Academy’s top advocacy priority.
CMS included two different conversion factors mandated by the Medicare Access and CHIP Reauthorization Act (MACRA) starting in 2026. Physicians who are qualifying participants (QPs) in advanced alternative payment models (A-APMs) will receive a higher conversion factor update and, thus, higher Medicare payments in 2026 compared to physicians who are not QPs as follows:
Non-QPs: $33.40, an increase of $1.05 (3.26%). (Most dermatologists will fall into this category. Check your QP status using your NPI number.)
QPs in A-APMs: $33.57, an increase of $1.22 (3.77%).
Both conversion factors included a one-year 2.5% increase for 2026 provided by the One Big Beautiful Bill Act that was enacted earlier this year.
While the increase is a bit of good news, CMS also finalized an “efficiency adjustment” policy, opposed by AADA, that will reduce payments for non-time-based services by 2.5%, beginning in 2026. CMS’s rationale for this cut is that increased physician efficiency and technological advances over time have reduced the value associated with many services. However, CMS will exempt evaluation and management codes, services on the CMS telehealth list, and new codes for 2026 from the reduction. On Nov. 3, AADA joined (PDF) over 30 medical organizations urging Congress to block this “efficiency adjustment,” which is unsupported by evidence and threatens physician payment and patient access.
CMS will also implement major practice expense changes, which are expected to reduce payments for dermatology services in facility settings by 13%.
The AADA remains fully committed to securing meaningful Medicare physician payment reform that will meet the contemporary needs of the dermatology community. We continue to call on Congress to enact legislation that provides an inflation-based update and fixes the structural flaws in the Medicare payment system.
AADA staff are reviewing the final rule and will provide an in-depth analysis on AAD.org. For more information, please review the final rule, the CMS press release, and the Medicare Physician Fee Schedule fact sheet.
Government Shutdown
Shutdown Update: Telehealth remains the exception in Medicare claims
As of Oct. 21, CMS directed all Medicare Administrative Contractors (MACs) to resume payments for most Medicare claims, including those under the Physician Fee Schedule, ground ambulance, and Federally Qualified Health Center (FQHC) programs, however, telehealth remains the exception.
The temporary telehealth provisions established during the COVID-19 Public Health Emergency were not extended by Congress and expired Sept. 30. Currently, MACs are instructed to process only telehealth claims that can be clearly identified as behavioral and mental health services. All other telehealth and Acute Hospital Care at Home claims remain on temporary hold pending further CMS guidance.
In the event your Medicare patient wishes to receive telehealth services that Medicare no longer covers, you must issue an Advance Beneficiary Notice of Noncoverage.
For additional information and ongoing updates, please visit the AAD 2025 telehealth flexibilities and policy updates webpage.
Drug Access
Members report difficulty obtaining Kenalog
The Academy recently heard from members experiencing challenges obtaining Kenalog (triamcinolone acetonide) for injection. Reports indicate difficulty sourcing both vials and compounded syringes, across various concentrations and from multiple manufacturers.
While this product is not currently listed on the FDA Drug Shortages database, we are closely monitoring the situation and gathering information from our members to better understand the scope and potential impact.
If you are encountering similar issues accessing this medication, please contact us at regulatory@aad.org.
AADA News
ASDS annual meeting SkinPAC fundraiser
Join SkinPAC for a breakfast event at the ASDS Annual Meeting in Chicago on Thursday, Nov. 13. The breakfast will be held from 7-8 a.m. at the Hyatt Regency Hotel, Room Michigan 3. The event is open to all 2025 SkinPAC donors who contribute $250 and above ($25 or more for Residents). Kick off the day by enjoying a hot breakfast and networking with your colleagues!
Contributions to SkinPAC will be accepted on-site in Chicago, but you can contribute early by visiting www.skinpac.org or by texting SkinPACASDS to 41444. RSVP to skinpac@aad.org.
AADA News
Contribute to SkinPAC
As of Oct. 31, SkinPAC has raised $955,958 from 840 individuals. Contribute online at www.skinpac.org or by texting SkinPAC to 71777. SkinPAC helps strengthen our relationships on Capitol Hill and reinforces our grassroots and lobbying efforts.
Email skinpac@aad.org with any questions.
The political purpose of the American Academy of Dermatology Association Political Action Committee ("SkinPAC") is to solicit and receive contributions to be used to make political campaign expenditures to those candidates for elective office, and other federal political committees, who demonstrate understanding and interest in the view and goals of the American Academy of Dermatology Association.
Contributions to SkinPAC are not deductible for federal income tax purposes. Contributions to SkinPAC must be made from your funds and may not be reimbursed. SkinPAC cannot accept contributions from corporate accounts. Any recommended contribution amount is merely a suggestion. All AADA members have the right to contribute more or less or refuse to contribute without reprisal. Federal law prohibits us from accepting contributions from foreign nationals. Federal law requires us to use our best efforts to collect and report the name, physical address, occupation, and name of the employer whose contributions exceed $200 in a calendar year.
