This proposed rule from the Centers for Medicare & Medicaid Services (CMS), issued on July 14, 2026, seeks public comment on payment updates and policy changes to Medicare’s physician fee schedule payments and includes other proposals affecting Medicare beneficiaries.
As required by statute, in 2026 CMS is implementing two separate conversion factors, one for participants of qualifying alternative payment models (APMs) and one for providers not participating. The proposed conversion factor for 2027 projects a decrease of –1.19% for APM providers, and a decrease of –1.68% for non-participant providers. Additionally, CMS is proposing to limit billing of remote patient monitoring services (RPMs) to clinical staff of a practice, no longer allowing billing for RPMs performed by third party contractors or vendors.
CMS also proposes to change the office/outpatient evaluation and management (O/O E/M) visit complexity add-on code, HCPCS code G2211, to a modifier appended to E/M base codes that will increase the payment by 16%. CMS is proposing a second modifier code only available to participants in the Medicare Shared Savings Program (MSSP) and LEAD ACO model that will increase the value of the base E/M code by 32%, among other major changes to the Medicare Shared Savings Program. CMS is proposing major changes to how practice expenses are calculated, a reduction of payments to evaluation and management (E/M) services billed on the same day as a global procedure, and new codes for advanced care planning.
Comment by September 14.