WASHINGTON November 5, 2026—Cuts in Medicare payments to physicians threaten to diminish access to care for Medicare beneficiaries, says the American College of Physicians (ACP). The Centers for Medicare and Medicaid Services (CMS) released the final 2027 Medicare Physician Fee Schedule yesterday, including several provisions that will reduce payments to physicians.

“Physician payments under Medicare have been subject to across-the-board cuts over the last several years due to budget neutrality requirements for Medicare. These cuts come on top of payment rates that haven’t increased in nearly two decades,” said Jan K. Carney, MD, MPH, MACP, FRCP, president of ACP. “When we combine that with inflation and drastically increased practice expenses, physician practices have been forced to try and keep the lights on with less and less. These payment rates are unsustainable and will ultimately result in decreasing access to care for Medicare beneficiaries.”

The 2027 fee schedule includes a decrease to the conversion factor that is used to calculate Medicare payments between 1.83 percent and 2.31 percent, depending on whether the physician is a qualifying participant in an Alternative Payment Model. The rule also includes a cut to services that are coded with modifier 25, a modifier used when an office visit is furnished the same day as a separate procedure. The cut was reduced from a 50 percent reduction that had been included in the proposed rule and is being finalized as a 20 percent reduction. ACP opposes this change that could undervalue distinct, medically necessary services and discourage physicians from addressing multiple patient needs during a single visit.

While ACP is concerned about the payment cuts, the rule does contain more positive steps for some Medicare programs and codes. CMS also delayed the transition from traditional Merit-based Incentive Payment System (MIPS) reporting to MIPS Value Pathway (MVP) until the 2031 performance period, providing physicians two additional years to prepare. MVP is a major change in how physicians will report quality performance under Medicare’s Quality Payment Program and the additional two years will help physicians to better prepare for the changes. ACP is encouraged that CMS responded to concerns regarding remote physiological monitoring (RPM). However, the finalized policies must preserve access to RPM services for patients with chronic conditions and avoid creating additional administrative and financial barriers for internal medicine physicians, especially those in smaller practices.

CMS also finalized changes to add-on code G2211 making it a modifier to an associated evaluation and management code. This is meant to better recognize the complexity of longitudinal care, but it is important for those payments to reach the internal medicine physicians and other primary care physicians performing those services in order to make a meaningful difference.

“We need a permanent payment fix that will stabilize Medicare physician payments and protect access to care,” concluded Dr. Carney. “While the 2027 fee schedule contains some provisions that will increase payments for specific services or practice models, these types of targeted improvements cannot substitute for the broader structural changes that our payment system desperately needs.”

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About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 172 countries worldwide. ACP membership includes 163,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on X, Facebook, Instagram, Threads and LinkedIn, and subscribe to our new RSS feed. 

Contact:  Jacquelyn Blaser, (202) 261-4572, jblaser@acponline.org