CMS released the CY 2027 proposed rule on July 14, 2026. The final rule is expected in November and takes effect January 1, 2027. This page tracks every proposal that touches the guides and tools.
| Item | 2026 | Proposed 2027 |
|---|---|---|
| Conversion factor | $33.40 (non APM), $33.57 (qualifying APM) | $32.84 (non APM), $33.17 (qualifying APM) |
| G2211 | Separate add-on code, 0.33 wRVU | Modifier on the office visit, visit payment plus 16 percent |
| Same day E/M plus procedure | Each service paid under the modifier 25 and 57 rules | Highest valued service in full, additional same day services at 50 percent |
| Telehealth | Office codes with POS 10 or 02 (modifier 93 for audio only); 98016 paid alone | Unchanged; flexibilities run through December 31, 2027 |
The proposed rule is CMS-1848-P (91 FR 43842). The public comment period closed on September 14, 2026, so new comments can no longer be filed; the final rule is expected about November 1. Follow the rule on the CMS page, read the CMS fact sheet, or read the comments already submitted. Once the final rule is out, the place to be heard is your specialty society and your members of Congress.
The proposed conversion factor is $32.84 for clinicians outside advanced APMs (2026: $33.40) and $33.17 for qualifying APM participants (2026: $33.57). The drop comes from the expiry of the one year 2.5 percent increase. It affects every dollar figure on the site that starts from the Medicare rate; the wRVU values themselves are separate and do not move with it.
CMS proposes to delete G2211 as a code and replace it with a modifier appended to the office visit, increasing that visit's payment by 16 percent instead of paying a flat amount. The underlying rule, longitudinal responsibility for the patient, is unchanged. What changes is the arithmetic: the add-on rises and falls with the visit level.
Affected: the G2211 chapter, the G2211 question page, the Note Coding Assistant engine, and every example that uses 0.33 wRVU.
When a visit and a procedure are billed on the same day, the highest valued service would pay in full and each additional same day service would pay at 50 percent. This lands on modifier 25 and modifier 57 claims for Medicare and reshapes the injection plus evaluation day.
Affected: the modifier 25 chapter, the joint injection question page, the modifier 57 question page, and the orthopaedic and sports medicine chapters.
Medicare would continue to decline the 98000 to 98015 family and continue to accept office codes with place of service 10 or 02 and modifier 95 or 93, paying 98016 alone. The current flexibilities run through December 31, 2027. Affected: the telehealth question page.
Nothing changes in your documentation until January. Comments on the proposed rule were due September 14, 2026. This page and the changelog will carry the final rule the week it publishes.