Medicare Billing Changes for 2027
Changes from CMS's final 2027 Physician Fee Schedule that hit every practice billing Medicare Part B on January 1, 2027.
Medicare 20272027 Medicare Physician Fee Schedule: What the 2.31% Pay Cut Means for Your PracticeMedicare's 2027 conversion factor drops to $32.63, a 2.31% cut starting Jan 1, 2027. Here's what it means for practice revenue and 6 steps to take now.Read the guide →Medicare 2027Medicare's 2027 Same-Day Visit Cut: How Modifier 25 Billing Changes With Minor ProceduresFrom Jan 1, 2027, Medicare pays 80% for the lower-paid service when a modifier 25 visit and a 0-day global procedure happen the same day. What to do.Read the guide →Medicare 2027G2211 Is Changing in 2027: How Medicare's New B1 and B2 Modifiers WorkIn 2027 Medicare replaces G2211 with modifier B1 (+16% to the E/M payment) and B2 (+32% for ACO and LEAD participants). Here's how to update your billing.Read the guide →Medicare 20272027 Medicare Changes to RPM, RTM, Advance Care Planning and Group Visits: A Practice Owner's Guide2027 Medicare rules: initiating visit for RPM/RTM, RTM for established patients only, new ACP codes G0572/G0573 and group-visit codes. What to change.Read the guide →
Medicaid & Payer Policy Updates
State-by-state Medicaid managed care and commercial payer rule changes that affect what gets paid.
Medicaid & payersUnitedHealthcare Community Plan Lab Testing Limits: State-by-State Guide for Practices (Oct 2026 to Jan 2027)UHC Medicaid plans now limit testosterone, B12, liver fibrosis, allergy and other lab tests. See which tests, which states, the dates and what to do.Read the guide →Medicaid & payersUnitedHealthcare Community Plan Billing Rule Changes in Kentucky, Maryland, Massachusetts and Wisconsin (Plus a Nationwide OB Change)UHC Medicaid: 50% cut for same-day sick + preventive visits in KY, lower modifier 78 pay in MA/MD, multi-procedure cuts in WI, OB changes in 2027.Read the guide →
No Surprises Act & Payment Disputes
Out-of-network billing and federal independent dispute resolution (IDR) updates.
This article explains payer and CMS rules in plain language for practice owners. It is not legal advice. Rules can change after publication, so always confirm against the source document before changing how you bill. Last reviewed November 9, 2026.