Medicare’s benchmark for paying physicians and other clinicians will fall in 2027 under a final rule issued by the Centers for Medicare & Medicaid Services. A temporary increase Congress provided for 2026 is expiring, and the smaller updates that apply for 2027 do not fully offset it.
Two benchmarks will decline
CMS set the 2027 conversion factor at $32.95 for clinicians who qualify through an advanced alternative payment model, down from $33.57. For other clinicians, it falls to $32.63 from $33.40. CMS calculates the declines at 1.83% and 2.31%, respectively. The agency attributes part of the change to the expiration of a one-year 2.5% increase, with other statutory updates and a separate adjustment also reflected in the final figures.
The conversion factor is one input in the fee schedule. Medicare applies it to values assigned to individual services, so the change in that factor alone does not tell a practice what it will receive for a particular visit or procedure. CMS also finalized changes to the way it assigns indirect practice expenses to services. Those adjustments can affect how payments vary across services and specialties.
When the changes take effect
CMS put the rule on public inspection Nov. 4 and lists Nov. 9 as its Federal Register publication date. The agency says the policies take effect on or after Jan. 1, 2027. The CMS rule page includes the final addenda and supporting files for comparing individual billing codes.
This schedule covers services billed by physicians and other professionals. It is separate from the 2027 rule for hospital outpatient departments and ambulatory surgery centers, which sets payment policies for those facilities.