09/14/2026
Proposed 2027 Medicare Physician Fee Schedule Raises New Concerns for Ohio Physicians
OSMA has filed formal comments with CMS on behalf of Ohio’s physician community, as the cost of practicing medicine keeps rising while Medicare physician payment continues to fall behind.
The Centers for Medicare & Medicaid Services (CMS) recently released its proposed 2027 Medicare Physician Fee Schedule, which would again reduce Medicare payment rates for many physicians beginning January 1, 2027.
Under the proposal, CMS estimates the 2027 conversion factor would decrease by approximately 1.68% for physicians who are not qualifying participants in an Advanced Alternative Payment Model (APM) and 1.19% for qualifying APM participants compared with 2026 payment levels. The reductions are driven in large part by the expiration of a temporary 2.5% Medicare physician payment increase that Congress enacted for 2026.
The Ohio State Medical Association has formally submitted comments to CMS regarding the proposed 2027 Medicare Physician Fee Schedule, ensuring that the concerns and perspectives of Ohio physicians are part of the federal rulemaking record.
The Growing Gap Between Payment and the Cost of Care
For physicians, however, this is about much more than a percentage on a fee schedule.
Medical practices are facing higher expenses for staff, technology, supplies, professional liability coverage, regulatory compliance and nearly every other component required to provide patient care.
Yet Medicare physician payment has not kept pace.
According to the American Medical Association, the cost of operating a medical practice increased approximately 63% between 2001 and 2026, while Medicare physician payment increased only about 10% during that same period. When adjusted for practice-cost inflation, Medicare physician payment has declined approximately 33%.
That growing imbalance has real consequences.
When reimbursement fails to reflect the cost of delivering care, physician practices are forced to make increasingly difficult decisions about staffing, investment in new technology, the services they can provide and, in some cases, the number of Medicare patients they can reasonably accommodate.
Independent, small and rural practices can be particularly vulnerable to continued payment instability. Over time, those pressures can also accelerate consolidation and make it more difficult for patients to access physician-led care in their own communities.
A sustainable Medicare payment system is therefore not simply a physician reimbursement issue—it is a patient access issue.
The 2027 Proposal Goes Beyond the Conversion Factor
The proposed rule also contains significant changes to how physician services would be valued and reimbursed.
Among them, CMS is proposing changes to the methodology used to calculate practice expenses, modifications to payment for evaluation and management services, and a policy that could reduce payment when certain office or outpatient E/M services are performed on the same day as procedures with global periods. Under that proposal, the highest-valued service would be paid at 100%, while additional qualifying services could be paid at 50%.
Changes like these can affect specialties differently and create consequences well beyond the headline conversion-factor reduction.
That is why physician involvement in the federal rulemaking process matters.
OSMA Is Making Ohio Physicians' Voices Heard
OSMA's advocacy is focused on the real-world impact federal payment policy has on physicians, medical practices and the patients they serve.
Physicians should be able to focus their time and resources on delivering high-quality care—not continually absorbing reimbursement reductions while the costs of running their practices increase.
Submitting formal comments is one part of OSMA's broader work to advocate for a healthcare environment in which physicians can maintain sustainable practices, preserve physician-led care and continue serving patients throughout Ohio.
What Happens Next?
CMS is accepting public comments on the proposed rule through September 14, 2026. After reviewing submitted comments, CMS will issue its final 2027 Physician Fee Schedule later this year.
OSMA will continue to monitor the rulemaking process and keep members informed as the final policies develop.
This is why organized medicine matters.
Decisions made in Washington can directly affect how physicians practice, how practices operate and whether patients can continue accessing care in their communities. OSMA will continue making sure Ohio physicians have a voice in those decisions.
Review the proposed 2027 Medicare Physician Fee Schedule and related CMS materials >
OSMA will provide additional updates when CMS releases the final 2027 Physician Fee Schedule.