CMS proposes Medicare physician payment and billing rule changes

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule for the calendar year 2027 Medicare Physician Fee Schedule. The rule would cut overall physician reimbursement by about 2.5 % but raise payments for endocrinology services by the same margin, transition the complex‑care code G2211 to a MOD1 modifier reimbursed at 16 % of the associated E/M code, and increase the rate for fine‑needle aspiration procedures. It also requires an initiating visit—either in‑person or via telehealth—before providers can bill for remote physiologic or therapeutic monitoring services.

In a separate provision, CMS suggested revising its Medicare revocation authorities by removing the four existing factors used to assess “abuse of billing privileges.” The agency argues the change will give it greater flexibility to revoke billing privileges when providers exhibit non‑compliant billing patterns, without being constrained by the current framework.