CMS Finalizes CY2027 Physician Fee Schedule Overhauling Medicare Payment

CMS finalized the CY 2027 Medicare Physician Fee Schedule, which it says shifts payment incentives from volume-based "sick care" toward prevention and coordinated primary care. The rule sunsets the traditional MIPS reporting option starting with the CY 2031 performance period, giving clinicians through CY 2030 to move to MIPS Value Pathways or Advanced Alternative Payment Models, and finalizes three new MVPs for diabetes, hypertension, and hospitalists. It expands the Medicare Shared Savings Program by letting approved ACOs eliminate Part B cost-sharing for assigned beneficiaries starting April 1, 2027, and increases shared savings rates for eligible ACOs. The rule also reduces payment by 20% for the lower-cost service when an office visit and minor procedure occur the same day, and closes an incentive payment loophole CMS estimates will prevent $2.38 billion in windfall payments over a decade.