July 14, 2026

2027 Medicare Physician Fee Schedule Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) released the 2027 Medicare Physician Fee Schedule (PFS) proposed rule this afternoon, which includes proposed changes to Merit-based Incentive Payment System (MIPS) and alternative payment model (APM) participation options and requirements for 2027. Key proposals include:

• Setting the 2027 Medicare payment rates for physician services. CMS proposes a conversion factor of $33.1693 for qualifying APM participants (QPs) and $32.8409 for non-QPs (-1.19% for QPs and -1.68% for non-QPs over final 2026 rates). This includes a +0.75% and +0.25% adjustment for QPs and non-QPs, respectively, as required by statute;
• Setting the 2027 anesthesia conversion factors at $20.4165 for QPs and $20.2143 for non-QPs (-0.89% and -1.38% over final 2026 rates);
• Sunsetting traditional MIPS as a reporting option following the 2028 performance period/2030 MIPS payment year and transitioning to MIPS Value Pathways (MVPs) beginning with the 2029 performance period/2031 MIPS payment year;
• Adding three new MVPs related to diabetic disease, hypertension, and hospitalist;
• Reforming the methodology for assigning practice expense relative value units (RVUs) to specific services;
• Transitioning evaluation and management (E/M) visit complexity add-on code, HCPCS code G2211, to a modifier that can be appended to the associated E/M base code;
• Reducing payment when a separately identifiable E/M visit is furnished by the same physician (or a physician in the same practice) on the same day as a 0-, 10-, or 90-day global procedure;
• Making numerous changes to the Medicare Shared Savings Program (MSSP), such as modifying the financial methodology, updating beneficiary assignment methodology, allowing all MSSP accountable care organizations (ACOs) to reduce or eliminate Part B cost sharing, and adding a new modifier for providing longitudinal care;
• Revising participant exceptions, quality measures, and benchmarking and scoring policies for the upcoming Ambulatory Specialty Model (ASM) for specialists commonly treating people with Original Medicare for heart failure or low back pain beginning January 1, 2027.

MGMA will submit detailed comments in response to these proposals to CMS and prepare a more detailed analysis of proposed changes in the coming weeks. Review the proposed rule, the PFS Fact Sheet, the MSSP Fact Sheet, and the QPP Fact Sheet. The final 2027 PFS rule is expected by November 1, 2027.