ACP says 2027 Medicare payment proposal is a positive step for internal medicine physicians
WASHINGTON, July 15, 2026—The proposed 2027 Medicare Physician Fee Schedule was released by the Centers for Medicare & Medicaid Services (CMS) Tuesday afternoon. Many of the provisions in the proposed rule could help strengthen primary care and drive innovation, priorities for which ACP has long advocated, including provisions related to primary care payment, behavioral health, advance care planning and evaluation, and management (E/M) services.
ACP is encouraged that CMS is seeking input on redesigning primary care payment, including reconsidering how primary care is valued, the role of technology-enabled primary care and the potential use of prospective payment within the Medicare Shared Savings Program (MSSP). This presents an important opportunity to reinforce the need to appropriately value primary and preventive care and support a stronger, more sustainable primary care system.
Another positive development is CMS’s proposal to replace the G2211 code with a modifier that would increase payment by 16% of the base E/M service rather than providing a flat payment amount. This approach could better recognize variations in physician work across visit levels, provide greater payment for more complex longitudinal care and streamline billing by eliminating a separate claim line. CMS is also proposing an enhanced 32% adjustment for eligible physicians participating in MSSP ACOs and the LEAD model.
The proposed rule also includes payment increases for several services related to behavioral health and advance care planning, further supporting comprehensive care planning and the needs of an aging Medicare population.
ACP is also encouraged by proposed changes to remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services. CMS proposes requiring these services to be furnished only to established patients and requiring an initial visit before services begin. These changes would reinforce longitudinal, patient-centered care and help ensure that remote monitoring services are provided within an established clinical relationship.
The proposed rule also establishes separate conversion factors for qualifying participants in Advanced Alternative Payment Models (APMs) and other clinicians, as required by statute. While ACP continues to support policies that encourage participation in Advanced APMs, the expiration of the temporary 2.5% statutory payment increase means that both proposed 2027 conversion factors would represent reductions compared with 2026. ACP remains concerned about the impact of these reductions on the long-term stability and adequacy of physician payment under the Medicare Physician Fee Schedule.
Several other provisions in the proposed fee schedule and Quality Payment Program (QPP) rule are of interest to ACP and internal medicine physicians CMS is proposing to:
- Continue its examination of practice expense methodology, including movement toward more objective cost data and questions surrounding site-of-service payment differentials;
- Pause data collection on payment rates for global services based on the findings to date;
- Reduce payment when a separately identifiable office/outpatient E/M visit is furnished by the same physician (or a physician in the same practice) on the same day as a 0-, 10-, or 90-day global procedure;
- Make several notable changes to the QPP, including sunsetting traditional MIPS after the 2028 performance period and continuing the transition toward MIPS Value Pathways (MVPs);
- Add new MVPs for diabetes, hypertension, and hospitalists; and make modifications to all previously finalized MVPs;
- Replace the current outcome/high-priority measure requirement with a new MIPS core measure requirement; and
- Make changes to how Qualifying APM Participant (QP) and Partial QP determinations are made.
Taken together, many of these proposals appear intended to simplify reporting, improve clinical alignment, and continue moving clinicians toward more focused participation pathways.
ACP will continue reviewing the proposed rule in detail and will provide members with additional analysis. The College also looks forward to submitting comments to CMS on the proposals and their potential impact on internal medicine physicians, their patients and the health of the nation.
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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: Laura Baldwin, lbaldwin@acponline.org, 215-351-2668