What the 2027 Medicare fee schedule changes for care management and remote monitoring

The short version

• Conversion factor: $32.63 for most clinicians in 2027, down 2.31% from $33.40. For qualifying APM participants, $32.95, down 1.83% from $33.57.
• Remote monitoring from January 1, 2027: a separately reportable initiating visit is required at the start of RPM or RTM. RTM is limited to established patients. CMS also updated how these services are valued.
• Remote monitoring from January 1, 2029: Medicare will pay for RPM and RTM only when the clinical staff performing them are employed by the billing practice, not contractors.
• Care management: the CCM, PCM, TCM, and APCM codes continue. Their 2027 payment amounts change with the conversion factor and CMS’s practice-expense updates.

Payment: a lower conversion factor

Medicare converts each service’s relative value units into a payment amount using a conversion factor. For 2027 there are two: $32.63 for clinicians who are not qualifying APM participants, and $32.95 for those who are. Both are lower than in 2026 because a one-year statutory increase of 2.50% for 2026 expires.

For a practice, this means a 2026 benchmark is not a 2027 forecast. Rebuild any care-management estimate with the 2027 rate file before using it in a budget.

Remote monitoring: what is final for 2027

CMS proposed four changes to remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM), and finalized the first three for 2027:

• RTM services are furnished only to established patients.
• Practitioners reporting RPM or RTM must furnish a separately reportable initiating visit in association with the start of the service.
• CMS updated how these services are valued under the fee schedule.

Remote monitoring: the 2029 staffing requirement

The fourth change allows payment for RPM or RTM only when the service is performed by clinical staff employed by the practice, and not when it is delivered by contractors. After public comment, CMS delayed this requirement for two years, to January 1, 2029, to give practices time to adapt.

CMS also asked for comment on bundling the RPM and RTM codes into four new G-codes. It did not finalize that idea and may return to it in future rulemaking.

Care management: CCM, PCM, TCM, and APCM

Chronic Care Management, Principal Care Management, Transitional Care Management, and Advanced Primary Care Management continue in 2027. Each program’s eligibility, consent, personnel, and documentation requirements still apply, and each practice should confirm them against current CMS guidance before a rollout.

Compare the care-management programs · Read the APCM guide

Advance care planning by clinical staff

CMS finalized two new codes, G0572 and G0573, for advance care planning furnished by clinical staff under the direct supervision of the billing practitioner. The existing codes 99497 and 99498 report the practitioner’s own time.

What to do before January 1

• Decide who furnishes the initiating visit for each new RPM or RTM patient, and where it is documented.
• Confirm that new RTM patients are established patients of the billing practitioner.
• Rebuild 2027 estimates with the 2027 rates once your billing team has them.
• Review how your remote-monitoring clinical staff are engaged, ahead of the 2029 requirement.

Common questions

When does the 2027 Medicare Physician Fee Schedule take effect?

CMS issued the calendar year 2027 final rule on November 4, 2026. Its policies apply to services on or after January 1, 2027, except where CMS set a later date.

What is the 2027 Medicare conversion factor?

$32.63 for clinicians who are not qualifying APM participants, a decrease of $0.77 (2.31%) from $33.40. For qualifying APM participants it is $32.95, a decrease of $0.62 (1.83%) from $33.57.

Is an initiating visit required for remote patient monitoring in 2027?

Yes. CMS finalized that practitioners reporting RPM or RTM must furnish a separately reportable initiating visit in association with the start of those services. CMS also finalized that RTM is furnished only to established patients.

Can contracted staff still perform RPM and RTM services?

Under the final rule, the requirement that RPM and RTM be performed by clinical staff employed by the practice was delayed two years. It takes effect January 1, 2029. CMS said the delay gives practices time to adapt.

About the figures on our program pages

The code cards and estimators on MySeema’s program pages use 2026 Medicare rates and are labeled that way. They do not forecast 2027 payment.

This page summarizes a CMS final rule for planning. It is not a billing manual or a promise of reimbursement. Confirm requirements with your billing and compliance teams.