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Federal health policy for physician practices

Last filed

Reimbursement Watch

Practice-level health policy reporting

Federal health policy, measured in what it changes for your practice.

Each update is graded by direction, dated by when it takes effect and paired with the steps a practice can take now. CMS payment rules, Medicare and Medicaid policy, compliance obligations and FDA actions.

Latest updates

Every update, by section

Cut

CMS finalizes 2027 fee schedule: conversion factor down 2.31%, same-day E/M cut narrowed to 0-day globals

The final CY 2027 Physician Fee Schedule sets the main conversion factor at $32.63, a deeper cut than July's proposal. CMS also replaces G2211 with a percentage-based modifier and gives practices two more years before traditional MIPS ends.

The change Non-QP conversion factor falls 2.31% to $32.63; QP factor falls 1.83% to $32.95

First steps for your practice

  1. Load the 2027 conversion factors ($32.63 non-QP, $32.95 QP) into your Medicare fee schedule and revenue projections before January 1
  2. Retrain coders to replace G2211 with modifier B1 (or B2 for Shared Savings Program and LEAD ACO participants) on 2027 E/M claims
  3. Flag same-day modifier 25 E/M visits billed with 0-day global procedures, which will be paid at 80% when they are the lower-paid service

All 5 actions for this update

Effective
Filed
Sections
PaymentComplianceMedicare

Effective-date watch

When the changes we have covered take effect.

  1. Cut

    Non-QP conversion factor falls 2.31% to $32.63; QP factor falls 1.83% to $32.95

What we track

Every update is filed under one or more sections.

  • Payment1 update

    Fee schedules, conversion factors, OPPS and ASC rates, site-neutral payment, sequestration and No Surprises Act payment disputes.

  • Compliance1 update

    Reporting and documentation obligations: MIPS and quality programs, prior authorization, OIG guidance, Stark and anti-kickback rules, HIPAA and information blocking.

  • Medicare1 update

    CMS rulemaking and Medicare legislation: the physician fee schedule, telehealth, Medicare Advantage policy that reaches providers, and the payment fixes Congress debates.

  • Medicaid0 updates

    Federal Medicaid and CHIP rules and financing changes that alter what providers are paid.

  • FDA0 updates

    FDA actions that change clinical operations: drug shortages, device clearances and REMS changes.