Protecting Patient Access to
Office-Based Interventional Care
Who We Represent
OBFA is a national coalition of office-based interventional physicians and facilities committed to preserving patient access to community-based care. Our members provide essential procedures outside the hospital setting — delivering high-quality care at lower cost to the healthcare system.
We bring the real-world experience of private practice directly into Medicare policy discussions with Congress and the Centers for Medicare & Medicaid Services (CMS).
Office-Based Care is at Stake
HOSPITAL
AMBULATORY
SURGERY CENTER
OFFICE*
Most expensive setting | Cost less than hospitals | Lowest costs |
Emergent capabilities | General sedation | Conscious sedation |
All services | Surgical services | All minimally-invasive procedures** |
Mostly urban | Mostly urban | Urban and rural |
Most stringent CON restrictions | Less stringent CON restrictions | Least stringent CON restrictions |
*Many terms are synonymous with "office-based," such as "private practice," “freestanding,” “nonfacility,” or “place of service 11” and such providers often are independent physicians, small businesses, and rural providers.
**Such care crosses a wide range of specialties, including primary care, cardiology, interventional radiology, pain medicine, proton therapy, radiation oncology, urology, vascular surgery, and more.
Medicare Physician
Fee Schedule Cuts
From 2006 to 2025, office-based specialties were cut:
-
Physical Therapy -9%
-
Urology -9%
-
Cardiology -19%
-
Radiation Oncology -22%
-
Vascular -32%
-
Diagnostic -38%
-
IDTF -54%
Impact on Health System Consolidation
According to the American Medial Association from 2012 to 2024:
-
Private Practice decreased: -18%
-
Hospital employment/ ownership of physicians/ practices increased: +18%
Protecting Patient Access to Office-Based Interventional Care
Now – more than ever – patients need access to office-based interventional care.
The Problem
Medicare Physician Fee Schedules in the first half of this decade continued the long-term trend of cuts to office-based proceduralists. These year-over-year cuts have been implemented without regard to patient outcomes, actual PFS provider resource needs, or any other policy. These cuts also reduced patient access, particularly in rural areas; accelerated the health system consolidation trend; exacerbated health inequities in a variety of diseases; and threatened the pandemic resilience of our healthcare system.
The 2026 Medicare Physician Fee Schedule is the first CMS regulation in recent years that recognizes the plight of independent and private practice physicians by increasing reimbursement for office-based interventional providers. OBFA urges CMS and Congress to continue to build on these foundational changes by enacting legislation to focus the PFS on paying for the work of physicians and allied professionals and reimbursing separately for office-based practice expense.