Proposed 2027 Medicare Physician Fee Schedule and Payment Updates
The Centers for Medicare and Medicaid Services (CMS) introduced the proposed 2027 Medicare Physician Fee Schedule on July 14, 2026. The draft includes a reduction in the Physician Fee Schedule (PFS) conversion factor, decreasing it from $33.5675 to $33.1693 for APM participants and from $33.4009 to $32.8409 for non-qualifying APM participants. This represents a decline of $0.56, or 1.7%, from the current rate for non-qualifying participants.
Within the proposal, new Relative Value Unit (RVU) values are suggested for vestibular testing codes, following reviews by CPT and RUC. Specific codes under consideration include those for Rotational Vestibular Assessment and Video Head Impulse Testing (vHIT). The American Academy of Audiology plans to further review the proposed rule and intends to provide feedback by the September 14, 2026, deadline.
Medicare Reform and Payment Updates
For the 2027 calendar year, CMS aims to implement comprehensive reforms in Medicare physician payment and value-based care. These reforms seek to promote accountable care, modernize payment structures, reduce administrative tasks, and support a preventive, coordinated care approach. These changes are designed to enhance care quality, improve patient outcomes, and ensure Medicare's sustainability.
Additionally, CMS has unveiled the proposed rule for the 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. It includes updates to Medicare payments and policies for outpatient and ASC services. As part of these updates, CMS proposes a market basket increase of 2.5% for hospitals fulfilling quality reporting criteria, incorporating a 3.2% market basket increase minus a 0.7 percentage point productivity adjustment.
The proposal also contains a table of suggested APC payment rates for audiology services, aiding stakeholders in assessing the financial impacts of the proposed Hospital Outpatient Prospective Payment System (HOPPS) rule.