ASGE, ACG, and AGA jointly submitted a letter to the Centers for Medicare & Medicaid Services (CMS) on December 23, 2025, outlining shared concerns regarding proposed changes to the Practice Expense (PE) methodology and the potential impact on gastroenterology endoscopy services.
The letter—approved by leadership from the American Society for Gastrointestinal Endoscopy, American College of Gastroenterology, and American Gastroenterological Association—formally requested that CMS delay implementation of the revised PE methodology until the Agency completes a targeted, specialty-specific analysis and fully validates the policy’s effects on endoscopy services. The societies emphasized that the current approach may lead to unintended consequences and does not adequately reflect the variation in resource use, staffing, and infrastructure across different endoscopy practice settings.
In addition, the letter urged CMS to modify the policy beginning in CY 2027 to allow for appropriate differentiation among physician practice arrangements, ensuring that PE valuation more accurately aligns with how endoscopy services are delivered in real-world clinical practice.
A copy of the letter can be found here. We will continue to monitor CMS’s response and keep members informed of any developments or opportunities for further advocacy.