US CMS proposes 2027 Medicare Physician Fee Schedule changes and remote monitoring limits

On July 14, 2026 the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for the Calendar Year 2027 Medicare Physician Fee Schedule and Quality Payment Program. The proposal lowers conversion factors for both qualifying and non‑qualifying alternative payment model participants, removes the temporary 2.5% update applied in 2026, and adds a 0.53% budget‑neutrality adjustment. It also sunsets traditional MIPS reporting after the 2029 performance period, introduces three new MIPS Value Pathways focused on diabetes, hypertension and hospital‑based care, and updates advanced APM policies.

In a separate section, CMS seeks to curb fraud by restricting Medicare payment for remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services when performed by contractor staff. The rule would require services to be provided by a direct employee of the practice, limited to established patients, and tied to an initiating visit. It also proposes reduced valuation for RPM/RTM and new bundled HCPCS codes. The public comment period runs through September 14, 2026, with a final rule expected later this fall and an effective date of January 1, 2027.