Sending Office: Honorable Erik Paulsen
Sent By:

Dear Colleague,

Please join me in sending a letter to the Centers for Medicare & Medicaid Services (CMS) urging the agency to protect access to vital revascularization services integral to the effort of reducing amputations in Medicare patients with peripheral artery disease
(PAD). The 2019 Physician Fee Schedule (PFS) Proposed Rule is proposing to cut reimbursement for revascularization by up to 30% or more for critical codes. We have concerns with the accuracy of this data for revascularization codes as they have no pricing
data at all
 in the CMS database.  

It is estimated that 18 million people in the United States have PAD, which can lead to amputation. “Revascularization” is the process of restoring blood flow to the limb through minimally invasive surgery, a process which typically prevents the need for

On September 5, Rep. Payne and I hosted a briefing on the importance of policies to reduce amputation in patients with PAD and the significant racial disparities in amputation rates.  African Americans with diabetes, for example, are one of the most affected
populations with amputation risks as much as four times higher than the national average, as are veterans and Native Americans.  Revascularization is an important tool in preventing amputations in our nation’s elderly patients and critical to our efforts of
reducing racial disparities relating to amputations from this disease.

In order to protect revascularization services and make amputations a thing of the past, I invite you to a letter urging CMS to properly value critical revascularization services.  In particular, it is clear that the lack of any listed price for supply inputs
used in revascularization services means providers are not being reimbursed for the resource cost of those services. I expect that providers will submit their own comments to the 2019 Physician Fee Schedule Proposed Rule and the letter will urge CMS to work
with such stakeholders to properly value revascularization services.

If you would like to sign this letter, or have any questions, please reach out to Andy Franke (Paulsen) at


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