Conversion factor dips as CMS proposes cuts, floats major coding updates

Why This Topic Matters

The proposals and requests for comment could affect future Medicare payment policy and coding frameworks, making the article relevant to practices assessing potential operational and reimbursement changes.

Article Sections

1. Physician fee schedule

   Introduces the proposed CY 2027 Medicare physician fee schedule and summarizes the policy areas discussed in the article.

2. First up: Conversion factor cuts

   Covers proposed physician and anesthesia payment-factor changes for different participation groups, with a comparison to the prior year.

3. Keep watch: New codes on the horizon

   Surveys anticipated CPT updates across several clinical areas, including skin, musculoskeletal, spinal, and orthopedic services.

4. RFI: CMS questions abandoning the CPT code set, adopting ICD-10-PCS

   Describes CMS’s request for input on the CPT code set, ICD-10-PCS, and alternative approaches to code development and valuation.

5. Revisions to complexity of care payment, coding

   Discusses proposed changes related to complexity-of-care payment and coding for evaluation and management services.

6. More practice expense changes coming?

   Summarizes CMS’s request for feedback concerning practice expense assumptions and payment policy.

7. RFI redux: Primary care redesign?

   Covers CMS’s request for comment on potential primary care payment redesign, including evaluation and management, wellness, and care management services.