On Wednesday, Nov. 4, 2026, the Centers for Medicare & Medicaid Services (CMS) released the CY 2027 Medicare Physician Fee Schedule final rule. It includes significant changes to physician payment and the Quality Payment Program. An in-depth summary and assessment of the final rule will be available in the coming days. The following summary highlights immediate takeaways from the 2,400-page rule:
- Conversion factors will fall in 2027: 1.83% for APM qualifying physicians and 2.31% for non-APM physicians.
- Modifier 25: CMS finalized a payment reduction for same-day procedures, reducing payment for the lower valued service by 20% when an office/outpatient E/M is performed with a 0-day global procedure. The AOA opposes the cut and will urge Congress to delay implementation.
- MIPS: Traditional MIPS will continue through performance year 2030; its sunset is delayed to 2031.
- Maternity care: CMS withdrew its proposal for duplicative billing codes; an advocacy win for the AOA.
- E/M add-on: G2211 will transition to B1 and B2 modifiers, increasing payment by 16% and 32%, respectively, for eligible services.
This rule is only the beginning of our work. The AOA is advocating on your behalf and will continue to challenge policies that undermine fair physician payment and the ability to care for patients. We’ll be in touch soon with additional information and concrete ways you can take action.
Visit the AOA’s Medicare Physician Fee Schedule Grassroots page to follow our efforts and stay ready to make your voice heard.
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