Payer Desk

CMS published the CY2027 Physician Fee Schedule proposed rule on July 14. The conversion factor drops 1.68% for physicians outside advanced alternative payment models and 1.19% for those inside one — both from the expiration of the 2.5% increase Congress wrote for 2026 alone.

Underneath the cut, the rule reworks primary care payment. The G2211 complexity add-on becomes a percentage modifier rather than a flat add-on code. A second modifier pays ACO physicians double. Evaluation and management visits billed the same day as a procedure are cut in half. Traditional MIPS gets an expiration date.

This lands on every practice billing Medicare Part B, and hardest on those outside an advanced APM. Whether the G2211 rewrite helps or costs you depends on how much of your established-patient volume carries it today.

The same proposed rule would prohibit remote patient monitoring services from being delivered by contracted staff. If finalized, a practice running RPM through an outside vendor's personnel would need to bring that staffing in house or stop billing for it.

The provision has drawn organized opposition during the comment period, so it may not survive to the final rule in November. But contracts signed this fall will run into January, when the final rule takes effect.

This affects any practice whose RPM program is staffed by someone other than its own employees. Whether it changes anything for you depends on how your vendor agreement is structured — and that's worth knowing before a renewal date passes.

New, revised, and deleted diagnosis codes all land on the same day. There is no grace period. A claim submitted on or after October 1 carrying a deleted code denies.

The practical exposure isn't the new codes — it's the deleted ones sitting in EMR favorites, problem lists, and order sets that nobody has looked at since last October.

This affects every practice. Whether it costs you anything depends on which retired codes are still living in your most-used templates.