After this webinar attendees will be able t answer-

• What are the prpsed CY 2027 cnversin factrs, and why des payment fall when the statutry updates are psitive?
• When wuld a same-day ffice visit be paid at 50 percent instead f 100 percent, and which service n the claim keeps full payment?
• Which specialties did CMS identify as absrbing the largest reductin frm the same-day prpsal?
• What is CMS prpsing t d with HCPCS cde G2211, and what replaces it?
• Why wuld a percentage-based mdifier pay differently than a flat add-n, and which visit levels gain r give smething back?
• Wh may reprt the prpsed 32 percent accuntable care mdifier, and what des AC participatin nt establish n its wn?
• When is the cmplexity add-n payable tday alngside a visit carrying mdifier 25, and when is it nt?
• Are different diagnses required t reprt mdifier 25 with a same-day prcedure?
• What dcumentatin supprts a significant and separately identifiable visit n pst-payment review?
• Which claim edits and encunter templates shuld be crrected befre 1 January 2027?

Webinar details-

The CY 2027 Medicare Physician Fee Schedule prpsed rule changes what an ffice visit is wrth in three separate ways, and the claims mst affected are the nes practices bill every day. The cnversin factr falls. A separately identifiable visit furnished n the same day as a prcedure with a glbal perid wuld be paid at 50 percent whenever it is nt the mst expensive service n the claim. And HCPCS cde G2211, the visit cmplexity add-n practices spent three years learning t bill, wuld be deleted and replaced by a mdifier wrth a percentage f the base visit rather than a flat amunt.

This sessin wrks thrugh all three, using the arithmetic CMS published in the rule itself. That includes the agency's wn wrked dermatlgy claim, in which an ffice visit and tw lesin remvals are repriced line by line, and its demnstratin that a flat add-n raises a level tw visit by 29 percent but a level five visit by nly 9 percent. That gap is the reasn CMS gives fr mving t a percentage, and it is als the reasn the change is nt neutral fr any individual practice. Whether a practice gains r lses depends n which visit levels its cmplexity vlume already sits n.

The secnd half f the sessin turns t the rules that are already in frce and already generating denials, nne f which depend n the final rule. That includes the mdifier 25 limitatin n the cmplexity add-n, the narrw Medicare Part B preventive services exceptin and what falls utside it, the extensin t hme and residence visits that tk effect n 1 January 2026, and the dcumentatin that supprts a significant and separately identifiable visit when a reviewer asks. Attendees will als learn why different diagnses are nt required t reprt mdifier 25, a pint CMS states plainly and ne that is frequently misunderstd.

Every figure in the sessin is surced t CMS-1848-P and t CMS sub-regulatry guidance, with Federal Register citatins prvided. Prpsals are clearly identified as prpsals: the cmment perid clsed n

14 September 2026 and the final rule is anticipated later in the year, effective 1 January 2027. Attendees will leave able t mdel their wn expsure frm their wn claims data and t crrect the edits and templates that are csting them mney tday.

This webinar benefits the fllwing agencies-

• Physician practices and multi-specialty medical grups
• Surgical and prcedural specialty practices, including dermatlgy, tlarynglgy, pdiatry, phthalmlgy, rthpedics and clrectal surgery
• Primary care, internal medicine, family medicine and geriatric practices
• Urgent care centers and ambulatry clinics
• Hme-based and huse-call medical practices
• Skilled nursing facilities and pst-acute prviders
• Accuntable care rganizatins and value-based care prgrams
• Medical billing cmpanies and revenue cycle management vendrs
• utsurced cding, auditing and denial management firms
• Federally qualified health centers and rural health clinics
• Hspital-affiliated and prvider-based physician practices
• Healthcare cnsulting, cmpliance advisry and legal supprt firms

Wh shuld attend?

• Medical billers and billing managers
• Denial management and accunts receivable specialists
• Charge entry, claims and claim edit staff
• Revenue cycle managers and directrs
• Practice administratrs and practice managers
• Medical cders and cding managers
• Medical auditrs and internal review staff
• Cmpliance fficers, cmpliance managers and cmpliance analysts
• Physicians and practice wners
• Nurse practitiners, physician assistants and clinical nurse specialists
• Health infrmatin management prfessinals
• Practice CFs, cntrllers and finance directrs
• Accuntable care rganizatin and value-based care staff
• Billing cmpany and RCM vendr accunt teams
• Healthcare attrneys and regulatry cnsultants