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

Why This Topic Matters

The proposals described could affect how physician practices track Medicare payment policy and prepare for potential coding and practice expense changes. The article provides an overview of several areas where CMS is seeking input or proposing updates.

Article Sections

1. First up: Conversion factor cuts

   This section discusses proposed CY 2027 physician and anesthesia conversion factor changes, including comparisons with prior-year rates.

2. Calculating the proposed CY 2027 PFS conversion factor (CF)

   A chart presents proposed and prior-year conversion factor figures for different payment categories.

3. Keep watch: New codes on the horizon

   This section previews anticipated CPT code additions and revisions across several clinical areas, including skin, musculoskeletal, spine, and orthopedic care.

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

   This section summarizes CMS’s request for input on the CPT code set, ICD-10-PCS, and possible alternatives to existing code-development processes.

5. Revisions to complexity of care payment, coding

   This section covers proposed changes to complexity-of-care payment and coding for evaluation and management services.

6. More practice expense changes coming?

   This section discusses CMS’s questions about practice expense assumptions and possible approaches for physicians employed by healthcare organizations.