On July 14, 2026, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2027 Medicare Physician Fee Schedule (PFS) proposed rule, which includes policies related to Medicare physician payment and the quality payment program (QPP). Most policies, if finalized, would take effect January 1, 2027, unless otherwise noted.
Key takeaways from the CY 2027 PFS proposed rule
- Conversion factor (CF): The proposed CY 2027 physician CFs are $33.1693 for clinicians who are qualifying participants (QPs) in advanced alternative payment models (APMs) and $32.8409 for other clinicians – a decrease of 1.19% and 1.68%, respectively, from the final CY 2026 CFs.
- Practice expense (PE) changes: CMS proposes a major change to how indirect PE is calculated, built around three interrelated changes to the current methodology.
- Global procedures: CMS proposes changes to same-day billing of out-of-office evaluation and management (E/M) visits and global period procedures so that Medicare pays the most expensive service at 100% and all other surgical procedure(s) or E/M visit(s) at 50%.
- Remote patient monitoring (RPM) and remote therapeutic monitoring (RTM): CMS proposes significant policies that would establish additional criteria for and set new valuation of RPM and RTM services.
- Software as a medical service (SaMS) for laboratory services: CMS proposes to remove algorithm-only laboratory services from the Clinical Laboratory Fee Schedule and to pay for these services under the PFS, consistent with its approach detailed in the recently published CY 2027 Outpatient Prospective Payment System (OPPS) proposed rule.
- Merit-based Incentive Payment System (MIPS): CMS proposes to sunset traditional MIPS reporting in 2029 and transition clinicians toward MIPS Value Pathways (MVPs). The rule also introduces new MIPS core measures as part of its quality reporting requirements.
- Ambulatory Specialty Model (ASM): CMS proposes refinements to the ASM, making technical corrections and introducing streamlining changes that respond to stakeholder feedback from the CY 2026 PFS rulemaking process.
- Medicare Shared Savings Program (MSSP): CMS proposes reforms to MSSP payment methodology that stakeholders have long advocated for (most notably guardrails on the accountable care prospective trend) while aligning with the administration’s broader deregulatory agenda and easing the path toward digital quality measures (dQMs) by reducing administrative burden.
Comments on the proposed rule are due September 14, 2026.
Our full summary of the PFS proposed rule is for McDermott+ clients and McDermott+ Insider subscribers only; please contact your relationship consultant with questions. For inquiries, please contact us.
updated pfs-opps data dashboard
McDermott+’s new, interactive dashboard for PFS, Outpatient Prospective Payment System (OPPS), and Ambulatory Surgical Care (ASC) shows key information published by CMS for individual procedure codes. This includes for individual procedure codes (where applicable), the payment rate through the Medicare physician fee schedule, outpatient prospective payment system, and ambulatory surgical center payment system, plus status and payment indicators, geometric mean costs, device offset amounts, and other useful information.
This dashboard can be used by providers, device manufacturers, and the general public to see how Medicare payment rates for services of interest have changed across years.
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PFS RESOURCES
