2027 Medicare Physician Fee Schedule Proposed Rule: What Beneficiaries Should Know

On July 14, 2026, the Centers for Medicare & Medicaid Services released its proposed Calendar Year 2027 Medicare Physician Fee Schedule rule. The Physician Fee Schedule governs how Medicare pays physicians and many other practitioners for covered services, and the proposal also addresses several Medicare Part B policies.

The word proposed matters. These policies generally would take effect on or after January 1, 2027 only if CMS includes them in a final rule. A proposal is useful for seeing where Medicare policy may be headed, but it should not be treated as a current coverage promise or a reason to change plans today.

Much of the rule is technical and focuses on how Medicare pays clinicians. Several provisions, however, could affect how services are organized or made available. CMS proposes separate coding and payment for shared medical appointments, new coding for some advance care planning work performed by clinical staff, and changes involving diabetes education and nutrition services at Rural Health Clinics.

CMS also describes policies involving behavioral health, remote monitoring, primary care, and Medicare telehealth in certain rural clinic settings. These are not all the same kind of change: some would create or revise payment codes, some would implement laws already passed, and some simply request public comment for possible future policy.

CMS proposes recognizing Diabetes Self-Management Training and Medical Nutrition Therapy as qualified preventive services that can be billed as stand-alone visits under the Rural Health Clinic benefit. CMS says the goal is to align Rural Health Clinic payment with other settings and expand access for Medicare beneficiaries in rural areas.

That does not mean every nutrition visit or diabetes program would automatically be covered at no cost. Eligibility, referral or order requirements, provider qualifications, frequency limits, and Medicare cost-sharing rules can still matter. If the proposal is finalized, beneficiaries should confirm the service, clinic, and expected cost before an appointment.

The proposal includes regulatory changes tied to a 2026 law extending certain telehealth flexibility for Rural Health Clinics and Federally Qualified Health Centers through December 31, 2027. CMS says in-person visit requirements for mental health visits would not apply to services furnished through that date, and the law also extended payment authority for certain non-behavioral telehealth visits at those clinics.

Telehealth availability still depends on the service, provider, location, technology, and current Medicare rules. Before relying on a remote visit, ask the clinic whether it can bill Medicare for that exact service, whether an in-person visit is required, and what you may owe.

CMS proposes new coding and payment for shared medical appointments, where a clinician may provide guidance to a group of patients who have similar health needs. The proposal does not require anyone to receive care in a group. If this option becomes available, beneficiaries can ask how privacy, individual questions, follow-up care, and cost sharing would work.

CMS also proposes two new codes for advance care planning services furnished by clinical staff under a billing practitioner’s direct supervision. Advance care planning is a conversation about future medical decisions; it is not a requirement to choose a particular treatment. Beneficiaries should ask who will lead the conversation, how much time is included, and whether Medicare cost sharing applies in their situation.

The proposal projects changes to the conversion factors Medicare uses to calculate many clinician payments. Those payment rates can influence provider practices over time, but a percentage change in what Medicare pays a clinician is not automatically the same percentage change in a beneficiary’s premium, deductible, copay, or coinsurance.

Your actual cost depends on the covered service, Medicare-approved amount, whether a provider accepts assignment, any supplemental coverage, and—if you have Medicare Advantage—the plan’s network and cost-sharing rules. Do not use a headline about physician payment rates as a substitute for checking your own coverage.

For now, keep using current 2026 Medicare and plan documents. If a 2027 provision matters to your care, watch for the final rule and updated Medicare materials later in 2026. Ask your provider or clinic whether a service is currently covered rather than assuming a proposed policy already applies.

When comparing 2027 Medicare Advantage or Part D options, verify your county, providers, prescriptions, pharmacies, premiums, maximum out-of-pocket limit, prior authorization, and plan documents. The Physician Fee Schedule proposal does not replace those plan-specific checks, and it does not identify one plan as best for everyone.

CMS: “Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule,” issued July 14, 2026. Medicare.gov: information about costs in Original Medicare and whether providers accept assignment. These sources distinguish proposed 2027 policy from current coverage and explain why a provider payment amount is not the same as a beneficiary’s final out-of-pocket cost.