; and (3) by adding at the end the following new items: (bb) Amount specified For purposes of item (aa), subject to item (cc), the amount specified in this item is— (AA) for years before 2025, $20,000,000; (BB) for 2025, $53,000,000; and (CC) for 2026 and each subsequent year, the amount specified in this item for the preceding year. (cc) Indexing limitation on annual adjustments For 2030 and every subsequent fifth year, the Secretary shall increase the amount specified in item (bb) for such year by the cumulative increase in the MEI (as defined in section 1842(i)(3)) applicable to physicians’ services over the 5-year period ending on the last day of the preceding year. . 3. Budget neutrality corrections for overestimates and underestimates in utilization (a) In general Section 1848(c)(2)(B) of the Social Security Act ( 42 U.S.C. 1395w–4(c)(2)(B) ) is amended by adding at the end the following new clause: (vii) Budget neutrality corrections for overestimates and underestimates in utilization (I) In general In the case of a budget neutrality adjustment applied pursuant to clause (ii)(II) for an adjustment application year (as defined in clause (viii)(I)) beginning with 2025, with respect to an adjustment to relative value units made under clause (ii)(I), that is determined using estimated utilization (as defined in clause (viii)(III))— (aa) the Secretary shall, by not later than September 1 of the subsequent year— (AA) compare such estimated utilization to actual utilization occurring during such adjustment application year with respect to the adjustment to the relative value units made under clause (ii)(I); and (BB) if applicable, determine the extent to which, if any, the difference between the estimated utilization and such actual utilization affected the amount of such budget neutrality adjustment applied for such adjustment application year