Policy & oversight
Medicare Finalizes 2027 Doctor Pay Rule, Banning Remote Monitoring Vendors and Setting a MIPS Retirement Date
A rule finalized November 4 locks in a small physician payment cut, prohibits Medicare billing for remote monitoring services handled by outside vendors, and officially schedules the end of the MIPS quality program in 2031.
By the Goodsurance editorial teamNovember 5, 2026
The Centers for Medicare and Medicaid Services on November 4 finalized the calendar year 2027 Medicare Physician Fee Schedule, locking in several changes that affect both the physicians and the Medicare patients who rely on Part B coverage.
Physician payment rates will decrease modestly in 2027. The qualifying alternative payment model conversion factor drops to 32 dollars and 95 cents, from 33 dollars and 57 cents in 2026, a cut of about 1.83 percent. For physicians not in qualifying payment programs, the factor falls about 2.31 percent to 32 dollars and 63 cents. Both reductions partly reflect the expiration of a one-year 2.50 percent payment increase that Congress granted for 2026 only.
Starting January 1, 2027, only your own doctor's staff can run Medicare-covered remote monitoring. Here is what else changed in the new fee schedule rule.
A provision that drew significant opposition during the summer comment period also survived into the final rule. Starting January 1, 2027, Medicare will no longer pay for remote patient monitoring or remote therapeutic monitoring when the services are performed by an outside vendor company. Only clinical staff directly employed by the billing physician's own practice may furnish those services and collect Medicare payment. Advocates for rural patients and 32 House members urged CMS in October to withdraw the restriction, warning it could reduce access to home-monitoring programs in areas with fewer medical providers. CMS retained the requirement in the final rule.
The rule also sets a firm end date for the Merit-based Incentive Payment System. MIPS, the main quality-reporting track for Medicare physicians since 2017, will sunset with the 2031 performance year. Most physicians billing Medicare will need to transition into an alternative payment model before that deadline.
On billing accuracy, the rule reduces payment by 20 percent for the lower-priced service when a routine office visit and a minor procedure occur on the same day. CMS projects the change will prevent an estimated 2.38 billion dollars in unintended windfall payments over the next decade.
All changes take effect January 1, 2027.
In plain words
Medicare just finished a big rule about how much it pays doctors in 2027. Here is what changed.
Doctor pay will drop a little. A key payment number goes down about 1.83 percent for 2027.
Starting January 1, 2027, Medicare will not pay for remote health monitoring unless the doctor's own staff does the work. If an outside company set up your monitoring device or tracks your data, your doctor's office may need to change how that works. Groups that help patients in rural areas said this rule could make it harder to get monitoring in some places. Medicare kept the rule anyway.
Medicare's main quality-reporting program for doctors, called MIPS, will end in 2031. After that, most doctors will need to join a different kind of payment program focused on how well they care for patients.
Medicare will also stop paying twice for the same visit. If your doctor sees you and also does a small procedure on the same day, the lower-cost service will be paid less than before.
All of these changes start January 1, 2027.
Understand the basics first
Source: CMS
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