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E/M coding is one of the core elements of the medical practice revenue cycle process. Whether medical decision-making or time-based rules apply, it’s vital that practices, from physicians to coders, are fully up to speed.
 
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.
 
 
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.
 

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