Part B News | Editors' Blog

Breaking: Conversion factor dips as CMS proposes cuts, floats major coding updates

by: DecisionHealth staff Jul 14, 2026

Brace for impact: CMS announced a reduction to physician fees for CY 2027 that would, in aggregate, lower professional fees across services in 2027. The conversion factor (CF), one of CMS’ primary ratesetting mechanisms, would drop between 1% and 2% depending on the professional fee setting.

CMS also announced in the proposed 2027 Medicare physician fee schedule, released today, that it may seek an alternative method of calculating fees in a repudiation of the AMA’s valuation system. In fact, the agency questions whether it should move away from the CPT code set entirely. Also, CMS is eyeing a revamped system for primary care payments and is teasing new codes that are set to come online next year.

Facility-based specialists ask CMS for relief from indirect practice expense cuts

by: Julia Kyles, CPC Jul 10, 2026

Two physician groups asked CMS to exclude independent clinicians from the indirect practice expense reduction that went into effect Jan. 1. Their proposed solution includes the creation of a new modifier.

Telehealth claims continue to fall, as eligibility wavers

by: Julia Kyles, CPC Jun 26, 2026

The percentage of Medicare Part B patients who received a telehealth service declined to 23% in 2025 after holding steady at 25% for two years. Government turmoil and uncertainty might be responsible for the dip.

Breaking: CMS finalizes 190 new ICD-10-CM codes, deletes and revises others

by: Greg Hambrick with additional reporting by Julia Kyles, CPC Jun 5, 2026

Take note of the differences between the proposed and final versions of the ICD-10-CM code set. The ICD-10-CM Coordination & Maintenance Committee added six new codes that describe a personal history of gender transition (Z87.8901-Z87.8909 and Z87.893) that were not featured in the April release of the proposed codes. In addition, the committee changed course on its proposal to delete C75.9 (Malignant neoplasm of endocrine gland, unspecified).

Code swap: Remember that G0136 now covers physical activity, nutrition

by: Richard Scott May 28, 2026

Don't forget about a key change to a Medicare-covered HCPCS code that providers reported hundreds of thousands of times in its debut year. As of Jan. 1, code G0136 now covers physical activity and nutrition assessments, not social determinants of health (SDOH).

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