decisionhealth Newsletters, Coder Pink Sheets - 2026 Issue 7 (July)
Proposed 2027 Medicare Fee Schedule: Conversion factor dips as CMS proposes cuts, floats major updates
Subscribe or sign in to view the full article.
Article Overview
This article reviews selected provisions in CMS’s proposed 2027 Medicare physician fee schedule, including payment factors, orthopedic and other service valuation, potential CPT and ICD-10-PCS changes, primary care payment redesign, practice expense, and remote monitoring. It is intended for physician practices, billing and coding professionals, and others following Medicare policy. The article describes proposed changes and requests for information; it does not present final policy.
Why This Topic Matters
The proposals could affect physician practice payment and operations, while CMS’s requests for feedback address broader questions about code sets, valuation methods, and primary care. Understanding the topics under consideration can help readers assess the proposal’s relevance to their work.
Article Sections
-
First up: Conversion factor cuts
This section covers proposed physician and anesthesia conversion factor changes and payment topics affecting orthopedic practices.
-
Keep watch: New codes on the horizon
This section surveys anticipated CPT updates across several clinical areas, including skin, musculoskeletal, and spinal procedures.
-
RFI: CMS questions abandoning the CPT code set, adopting ICD-10-PCS
This section describes CMS’s request for information about CPT and ICD-10-PCS, including questions about code-set governance and alternative approaches.
-
Revisions to complexity of care payment, coding
This section covers proposed changes to payment and coding for complexity-related evaluation and management services.
-
E/M service + global surgery period procedure = Pay cut
This section addresses a proposed payment policy involving evaluation and management services reported alongside procedures with global periods.
-
More practice expense changes coming?
This section discusses CMS’s request for feedback on practice expense assumptions and approaches to valuation.
-
RFI redux: Primary care redesign?
This section outlines CMS’s request for feedback on possible primary care payment redesign, including evaluation and management, technology-enabled care, and prospective payment topics.
-
New rules for remote monitoring proposed
This section summarizes proposed policy topics for remote therapeutic and remote physiological monitoring, along with related requests for feedback.
What You Will Learn
- Which physician fee schedule payment areas CMS proposes to revise for 2027.
- What types of CPT updates and code-set policy questions CMS discusses.
- Which primary care payment, practice expense, and remote monitoring topics are under consideration.
- How the proposal addresses payment and reporting topics involving evaluation and management services.
Who Should Read This
- Physician practices and practice administrators
- Medical coders and billers
- Orthopedic practices
- Primary care professionals
- Anesthesia practices
- Healthcare compliance and reimbursement professionals
- Medicare policy stakeholders
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com