The Congressional Budget Office (CBO) recently released an updated estimate of the cost of last year’s bipartisan “SGR Repeal and Medicare Provider Payment Modernization Act of 2014” (H.R. 4015 and S. 2000).  The CBO had previously estimated that permanently replacing Medicare’s sustainable growth rate (SGR) formula as outlined in the bill would cost $144 billion over ten years.  Now, the CBO estimates that the current legislation would cost $174.5 billion between 2015 and 2025.  This estimate includes a provision in the bill that would sunset bonus payments for providers participating in alternative payment models.  The current Medicare payment rate for physician services expires on March 31, 2015.