Quick answer: CMS finalized the 2027 Medicare Physician Fee Schedule on November 4, 2026, effective January 1, 2027. Conversion factors fall to $32.95 for qualifying APM participants and $32.63 for everyone else, more than proposed. The same-day E/M cut was narrowed to 20% on 0-day global procedures, G2211 becomes modifier B1, and traditional MIPS runs through the 2030 performance period.
The July proposal set the agenda, and the final rule changed several numbers practices had already modeled. Here is what moved, what did not, and what to load before the first January claim. Our page on 2027 Medicare fee schedule changes has the full detail by topic.
What changed from the proposal
| Item | Proposed (July 14, 2026) | Final (November 4, 2026) |
|---|---|---|
| Conversion factor, qualifying APM participants | $33.17 (down 1.19%) | $32.95 (down 1.83%) |
| Conversion factor, everyone else | $32.84 (down 1.68%) | $32.63 (down 2.31%) |
| Same-day office visit and global procedure | All but the most expensive service paid at 50%; 0-, 10- and 90-day globals | All but the highest-paid service paid at 80%; 0-day globals only; modifier 25 visits by the same physician or a same-specialty colleague |
| G2211 | Placeholder modifiers MOD1 (16%) and MOD2 (32%) | Modifiers B1 (16%) and B2 (32%, ACO practitioners); G2211 no longer payable |
| Remote monitoring by employed staff only | From 2027 | Delayed to January 1, 2029 |
| End of traditional MIPS | After the 2028 performance period | After the 2030 performance period |
| High-complexity home sleep test interpretation (95849) | 1.42 work RVUs | 1.50 work RVUs |
| Maternity | New CPT codes; 15 G-codes floated | New CPT codes adopted; no G-codes |
The conversion factor fell further than proposed
Per the CMS final-rule fact sheet, the 2027 conversion factor is $32.95 for qualifying APM participants, down $0.62 from $33.57, and $32.63 for everyone else, down $0.77 from $33.40. Three things drive it. The one-year 2.50% increase Congress provided for 2026 expires. The statutory updates add 0.75% and 0.25%. And the budget-neutrality adjustment for work RVU changes came in at minus 0.12%, against the plus 0.53% CMS estimated in July. That swing is why the final factors are lower than proposed.
Most practices are not qualifying APM participants, so plan on a 2.31% lower conversion factor before any change in your own codes’ RVUs. Congress has changed physician payment after the final rule in past years, so recheck in mid-December and early January.
The same-day visit cut was narrowed, not dropped
When a separately identifiable office or outpatient visit, billed with modifier 25, falls on the same day as a 0-day global procedure, Medicare pays the highest-paid service in full and the others at 80%. CMS had proposed 50% and had included 10- and 90-day globals; the final rule drops both. It applies to the same physician or a physician of the same specialty in the same group, not a colleague in a different specialty. CMS projects the largest impacts on dermatology, otolaryngology and podiatry. The reduction can land on the procedure rather than the visit, whichever pays less.
G2211 becomes modifier B1 on January 1
For 2027 dates of service, CMS replaces the G2211 add-on with modifier B1, appended to the office/outpatient or home/residence E/M code. CMS says B1 increases the visit’s payment by 16% at every level. Modifier B2, at 32%, is limited to practitioners in Shared Savings Program ACOs and LEAD Model Participant Providers. The rule says G2211 will no longer be payable. The modifier 25 limit carries over unchanged: B1 and B2 do not pay on a modifier 25 visit unless the other service is an Annual Wellness Visit, a vaccine administration or another Part B preventive service. Keep G2211 for December visits and switch the charge rule on January 1.
Telehealth: two new modifiers, same 2027 runway
From January 1, 2027, telehealth claims need modifier BB when the service runs through a virtual platform the practitioner contracts with or pays to use, and modifier BC when it is furnished incident to a practitioner’s service. Neither changes payment. The broader flexibilities still run through December 31, 2027, and the in-person requirement for mental health telehealth is delayed to January 1, 2028; see mental health telehealth in 2028.
Other finalized changes worth a line
- Home sleep testing: 95843, 95844 and 95846 (technical) and 95847, 95848 and 95849 (interpretation) replace 95800, 95801 and 95806. See how to bill home sleep apnea tests in 2027.
- Maternity: Medicare adopts the CPT 2027 maternity codes and raised labor and delivery work RVUs about 15% above the RUC’s recommendations.
- Remote monitoring: RTM for established patients only and a separately reportable initiating visit start in 2027; the employed-staff rule waits until 2029.
- MIPS: traditional MIPS remains available through the 2030 performance period; MVPs or the APM Performance Pathway are required from 2031.
- Practice expense: CMS phases out the indirect practice cost index over two years, with a stabilizer to limit swings.
What to do before the first January claim
- Load the final conversion factors and CMS’s final Addendum B RVUs.
- Run last year’s modifier 25 visits against 0-day procedures on the same date and price the lower-paid service at 80%.
- Switch G2211 to modifier B1 for dates of service from January 1.
- Add BB and BC logic to telehealth claims.
- Load the new sleep and maternity codes and retire the deleted ones.
- Calendar a recheck in mid-December and early January.
If you want a second set of eyes on what the final rule does to your claims, start with a free billing analysis. AMS Solutions, physician-founded in 1992 and headquartered in Dallas, runs credentialing and medical billing services under one roof.
Frequently asked questions
What is the 2027 Medicare conversion factor?
$32.95 for qualifying APM participants and $32.63 for everyone else, down 1.83% and 2.31% from 2026, under the final rule CMS released on November 4, 2026.
Did CMS finalize the 50% same-day E/M reduction?
No. CMS finalized a 20% reduction instead, only when an office or outpatient visit billed with modifier 25 shares a date with a 0-day global procedure. The highest-paid service is paid in full.
Can I bill G2211 in 2027?
No. For 2027 dates of service, CMS replaces G2211 with modifier B1 on the office or home E/M code and says G2211 will no longer be payable. Practitioners in Shared Savings Program or LEAD ACOs can use modifier B2.
When do the 2027 changes take effect?
The final rule’s regulations take effect on January 1, 2027. The remote monitoring employed-staff requirement starts on January 1, 2029, and traditional MIPS remains available through the 2030 performance period.
Reviewed November 5, 2026.
Sources: CMS, Calendar Year (CY) 2027 Medicare Physician Fee Schedule Final Rule fact sheet (November 4, 2026); CMS, CY 2027 PFS final rule CMS-1848-F, Federal Register document 2026-22743 (public inspection November 4, 2026), including Tables D-B1 and D-B2, section II.C (telehealth modifiers) and section IV (MIPS); CMS, CY 2027 PFS final rule Addendum B; CMS, CY 2027 PFS proposed rule fact sheet (July 14, 2026). General information, not legal or coding advice.
