At the close of business on November 4, 2026, the Centers for Medicare & Medicaid Services (CMS) released the public inspection version of the Calendar Year (CY) 2027 Medicare Physician Fee Schedule (PFS) Final Rule,
outlining policy and payment changes that, if finalized, are effective on January 1, 2027. It is scheduled to post to the Federal Register on November 9, 2026. Below is a summary of the finalized policies particularly relevant to the provision of Medicare Part B therapy services.
CMS finalized a CY 2027 Non-Qualifying APM (NQ) conversion factor of $32.6286, which is a decrease of $0.77
(-2.31%) from the CY 2026 conversion factor of $33.4009. This cut is deeper than the -1.68% decrease originally
proposed, driven largely by a finalized budget neutrality adjustment of -0.12% (down from a proposed positive
0.53%). For Qualifying APM participants (QPs), the conversion factor is finalized at $32.9529, a decrease of
-1.83%.
The CY 2027 KX Modifier Threshold amount is $2540 for PT and SLP services combined and $2540 for
occupational therapy services.The threshold for targeted Medical Review for CY 2027 remains at $3000.
In a significant win for providers, CMS did not immediately finalize the proposal that would have required RTM and
RPM clinical staff to be directly employed by the billing practice. Following heavy industry pushback, CMS
delayed the "employed-staff" requirement for two years, shifting the effective date to January 1, 2029. Third-party
contracted staff can continue to be used through December 31, 2028, provided existing "incident to" rules are met
and the billing practitioner maintains meaningful oversight.
Established Patient and Initiating Visit Requirements
CMS finalized the policy requiring RTM services to be furnished exclusively to established patients.
Valuation & New RTM Codes
New SLP Treatment Codes with New Pediatric Code and Deletion of 92507
CMS finalized the deletion of CPT code 92507, replacing it with a highly stratified family of 10 new CPT codes
(92654–92663) to distinctly report fluency disorders, speech sound production disorders, language
comprehension, and voice/airway dysfunction.
MPPR Application for New SLP Codes: These codes are designated as "always therapy" services and must be
furnished under a therapy plan of care with the appropriate therapy modifier.
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