CMS proposes 2027 Medicare physician fee reductions

The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule for the 2027 Medicare Physician Fee Schedule, which suggests a decrease in payments for most physicians compared to 2026. The proposed conversion factor for clinicians who are not qualifying participants in an Advanced Alternative Payment Model (APM) is $32.8409, a 1.68% decrease. For qualifying APM participants, the proposed figure is $33.1693, a 1.19% decrease.

This reduction is largely attributed to the expiration of a one-year 2.5% increase provided by Congress for 2026. The proposed rule also includes a 50% payment reduction for office visits billed on the same day as a global procedure and a multiyear overhaul of practice expense methodology. Specialty impacts vary significantly, with clinical social workers seeing a projected 12% increase, while dermatology and otolaryngology face a 9% decrease.

Health policy experts note that these changes, along with administrative burdens like prior authorization, continue to impact practice operations. Experts suggest that the fee schedule may continue to favor larger organizations, potentially pressuring small practices to join larger conveners to maintain viability.