CY 2027 Medicare Physician Fee Schedule Proposed Rule Summary

On July 14, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) proposed rule and fact sheet for CY 2027 (CMS-1848-P). This rule updates payment policies and payment rates for Part B services furnished under the MPFS. The data files including Addendum B, which lists the proposed relative value units (RVUs) for each current procedural terminology (CPT®) code can be found here. Comments are due September 14.

With the release of this rule, CMS signals the possibility of moving away from the AMA CPT and Relative Value Scale Update Committee (RUC) process by creating or proposing several new HCPCS G codes, replacing CPT codes for payment in the Medicare program. Coinciding with the creation of new HCPCS G codes, the agency also outlines a request for information (RFI) asking stakeholders to provide information on the use of CPT codes for physician payment and if the use of CPT codes creates a payment system with contradictory incentives. This proposed rule also contains several other formal RFIs including ways to improve primary care and seeking improved payment methodologies for the global surgical package.

Throughout the CY 2027 rule, CMS seeks comments on several proposals, with many more opportunities for stakeholders to weigh in on proposed policies than in previous years. Finally, the Make America Healthy Again initiative, a priority of the administration, is prominent throughout with discussions on primary care, improving chronic care management, and creation of new HCPCS codes to support such care.