Inside the Proposed 2027 Medicare Physician Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) released the 2027 Medicare Physician Fee Schedule (PFS) proposed rule in July, reducing the PFS conversion factor from $33.5675 to $33.1693 for qualifying alternative payment model (APM) participants and from $33.4009 to $32.8409 for nonqualifying APM participants.

Overall reimbursement for cardiovascular services is projected to increase roughly 1% compared with 2026, including changes to policies and individual service values. Individuals and groups will see different impacts depending on patient populations and services offered.

Additional highlights from the proposed rule include:

• Technical refinements and adjustments to the Ambulatory Specialty Model (ASM), including clarifications for ASM participant exceptions due to Taxpayer Identification Number changes or redesignated cardiovascular specialty types.
• Proposed work, practice expense and liability inputs for newly created and revised cardiovascular codes, including cardiac contractility modulation, transcatheter tricuspid edge-to-edge repair, transcatheter tricuspid valve implantation, treatment of incompetent veins, intracoronary drug-coated balloon services, intravascular ultrasound, and left atrial appendage closure.
• A proposal to reduce E/M services billed on same day as a 0-, 10-, or 90-day global period by the same physician or practice by 50%.

For more updates regarding the Quality Payment Program, MIPS Value Pathways, the Medicare Shared Savings Program and Health IT, explore ACC Advocacy's deep dive.

ACC Submits Feedback on Proposed NCD For TAVR Determination

The ACC, along with the Society for Cardiovascular Angiography & Interventions (SCAI) and the Society of Thoracic Surgeons (STS), submitted formal comments to the Centers for Medicare and Medicaid Services (CMS) regarding the proposed decision memo for the National Coverage Determination (NCD) for TAVR.

Recommendations made by the societies include:

1. Preserve the multidisciplinary heart team model by explicitly requiring evaluation of eligible patients with severe aortic stenosis (AS) by both an interventional cardiologist and a cardiac surgeon and maintaining collaborative decision-making as a required component of care.
2. Maintain a targeted Coverage with Evidence Development (CED) pathway for patient populations where important evidence gaps remain, including bicuspid AS, valve reintervention, asymptomatic severe AS, aortic regurgitation and moderate AS.
3. Maintain mandatory participation in a national audited registry, such as the STS/ACC TVT Registry, and clarify how registry participation may be used to satisfy CED requirements and support quality measurement requirements.
4. Preserve nationally standardized approaches to quality measurement, benchmarking and continuous quality improvement through registry participation and externally benchmarked performance assessment.
5. Adopt a programmatic approach to facility and operator requirements that prioritize institutional performance, multidisciplinary infrastructure and quality outcomes over rigid operator volume thresholds alone.

"TAVR's success has been built on multidisciplinary heart team decision-making, participation in audited national registries like the STS/ACC TVT Registry, and rigorous quality oversight," says ACC President Roxana Mehran, MD, FACC. "As CMS considers updates to the TAVR [NCD], the ACC, in collaboration with our partner cardiovascular societies, supports modernizing the policy while preserving these proven safeguards and creating a flexible pathway to evaluate new technologies and indications, ensuring all patients have access to high-quality, evidence-based care."

Clinical Topics: Cardiovascular Care Team

Keywords: Cardiology Magazine, ACC Publications, CM-Sep-2026, Health Policy, Medicare, ACC Advocacy