Targeted Payment Reforms May Address the Shortage of Infectious Disease Physicians

A recent analysis from the Harvard Pilgrim Health Care Institute explores innovative approaches to mitigating the critical shortage of infectious disease (ID) physicians in the United States. The study focuses on the introduction of a new Centers for Medicare and Medicaid Services (CMS) add-on code specifically designed for ID specialists. This initiative marks a significant shift from traditional strategies, aiming to enhance physician reimbursement and, ultimately, improve healthcare delivery for populations in need.

Currently, ID physicians are among the lowest-paid medical specialists, despite their essential roles in pandemic response, antimicrobial stewardship, and public health. This pay disparity has contributed to declining interest in the field, with over half of ID fellowship positions expected to remain unfilled in 2024. As a consequence, vulnerable and rural populations face greater healthcare access challenges due to uneven distribution of ID providers.

In 2025, Medicare responded by implementing the new add-on code G0545 for inpatient ID consultations. This code increases reimbursement by approximately $28.80 per consultation, reflecting a 20% boost over previous rates. Services covered include disease transmission control, public health investigations, testing, and complex antimicrobial management.

Lead author Hao Yu emphasizes that ID physicians play a crucial role in managing emerging infectious threats, yet their compensation does not reflect the complexity of their work. The add-on code recognizes this discrepancy but leaves open questions about its long-term impact on salaries and workforce stability.

The authors propose three key strategies to ensure the effectiveness of this initiative:

1. Link payments to actual increases in physician salaries, possibly through transparency in hospital reporting and auditing mechanisms.
2. Implement location-based incentives with higher reimbursement rates for ID specialists practicing in underserved rural areas.
3. Treat the add-on code as a pilot program, with careful monitoring to assess its impact on addressing the ID physician shortage before expanding similar measures to other specialties.

The influence of Medicare policies extends beyond direct reimbursement, potentially setting the stage for national benchmarks if the initiative proves successful. As Tarun Ramesh notes, Medicare’s recognition of the value of infectious disease expertise sends a strong signal, but the benefits will only materialize if hospitals pass these financial incentives to physicians. Otherwise, the shortages and their adverse effects on patient care will persist.

In conclusion, targeted payment adjustments like the CMS add-on code offer a promising avenue to bolster the infectious disease workforce. Nevertheless, comprehensive evaluation and strategic implementation are critical to ensuring these reforms translate into tangible improvements in physician compensation and healthcare access for at-risk populations.

Source: https://medicalxpress.com/news/2025-06-payment-adjustments-infectious-disease-physician.html