Trump's Medicare cuts most doctors' pay 2.31% in 2027, deeper than first proposed

On Wednesday, Nov. 4, the Trump administration released its final rule on what Medicare will pay doctors in 2027. The rule cuts the program's base payment rate for most doctors and other clinicians. It takes effect Jan. 1, 2027 ¹¹².

The rate is called the conversion factor. It is the dollar amount Medicare multiplies by each service's assigned value to set the fee. For most clinicians it falls from $33.40 to $32.63, a 2.31% cut. Clinicians in qualifying alternative payment models, which reward doctors for holding down costs and meeting quality goals, see a 1.83% cut, from $33.57 to $32.95 ².

Both cuts go deeper than the ones the Centers for Medicare & Medicaid Services (CMS), the agency that runs Medicare, proposed in July. Those were 1.68% and 1.19% ³⁴.

Why the pay is falling

Most of the cut comes from a temporary raise running out. Congress gave doctors a one-year, 2.5% increase for 2026 in Public Law 119-21, and that raise expires ²⁶. Small increases required by law, 0.25% for most clinicians and 0.75% for those in qualifying payment models, make up only part of the loss ².

From Channel GOPJeffries: House Democrats have taken back CongressHakeem Jeffries · 150 plays · captioned, with the source named

By law, Medicare's yearly doctor-pay updates must be budget neutral. That means more money for one service has to be balanced by less for others. Healthcare Dive reports that this has left Medicare doctor pay behind the rising cost of care, and that Congress usually steps in with higher rates before cuts take effect ⁵.

CMS Administrator Dr. Mehmet Oz described the rule as a shift away from paying for volume ¹.

For too long, fee-for-service payment has rewarded volume over value, fueling a reactive system of sick care

"This final rule breaks from that status quo," Oz said. Health and Human Services Secretary Robert F. Kennedy Jr. said "Medicare should reward clinicians for keeping people healthy" ¹.

What changes at the doctor's office

Sometimes a patient gets an office visit and a minor procedure on the same day. Under the rule, Medicare will pay 20% less for the cheaper of the two. CMS first proposed a 50% cut and scaled it back after pushback from providers ⁵³. Dermatology, ear-nose-and-throat care and podiatry are among the specialties facing the largest hits from the rule's payment changes ³.

The rule lowers the value Medicare assigns to a surgeon's work on total hip and knee replacements, from 19.11 to 16.70 ³. The orthopaedic surgeons' group said the cuts first proposed "were reduced by nearly 50%" ⁴.

Some changes could help patients directly. Starting April 1, 2027, accountable care organizations (ACOs) approved by CMS may reduce or eliminate Part B cost-sharing for many services for patients assigned to them ¹. ACOs are networks of doctors and hospitals that share in the savings when they hold down costs. Part B is the part of Medicare that covers doctor visits. Medical equipment and prescription drugs are excluded from the waiver ⁶.

The rule also establishes payment pathways for health and well-being coaching and dedicated billing for shared medical appointments, and finalizes two new billing codes for advance care planning ¹³.

Payments for regular office visits get a 16% boost through a new billing modifier, and a 32% boost for practitioners in shared savings program ACOs and LEAD model participant providers ⁷²⁶.

Home monitoring rules delayed

Remote patient monitoring sends readings, such as blood pressure, from a patient's home to the doctor. CMS wants only staff employed by the billing practice to provide these services, but it delayed that requirement to Jan. 1, 2029. Practitioners billing remote monitoring must furnish a separately reportable initiating visit when services begin, and a related therapy-monitoring service will be limited to established patients ².

Caroline Pearson of the Peterson Center on Healthcare called the monitoring changes "a check against the rapid growth of these services" ⁴.

Doctors' groups turn to Congress

Physician groups criticized the rule right away ⁴⁵.

further degrade an already fragile payment system

The American Academy of Family Physicians said, "Physicians will once again begin the year with lower rates as practice costs continue to rise" ⁶. The Primary Care Collaborative said budget-neutrality rules mean across-the-board cuts on Jan. 1 unless Congress acts, and its president and CEO, Ann Greiner, urged Congress to address the cuts ⁴.

The Medical Group Management Association wants Congress to fix the conversion factor and the same-day payment change immediately. It also backs comprehensive reform of Medicare's doctor-pay formula through the Patients First Act ⁴. That bill, H.R. 9693, was introduced July 15 by three physician lawmakers: Republican Reps. John Joyce of Pennsylvania and Greg Murphy of North Carolina, who co-lead the GOP Doctors Caucus, and Rep. Kim Schrier, D-Wash., who leads the Democratic Doctors Caucus ⁹.

The pattern is familiar. In March 2025, Republicans passed a government funding bill with no fix for the doctor-pay cuts that had begun that January. Rep. Ami Bera, D-Calif., a physician, and five other Democratic doctors in the House warned that the cuts would "further drive up costs for seniors" ⁸.

Now the Republican majority has excluded any physician payment relief for the second time, and patients will pay the price.

That matters because the timing is tight. The current Republican Congress has until the end of December to act before the cut lands. Democrats won both chambers on Tuesday ¹⁰. Medicare's open enrollment period, when seniors can change plans, runs through Dec. 7 ⁹.

The Record

1. Mar 13, 2025Six Democratic doctors in the House, including Rep. Ami Bera, faulted Republicans for passing a funding bill with no fix for Medicare doctor-pay cuts that began Jan. 1, 2025 ⁸.
2. Jul 14, 2026CMS proposed 2027 cuts of 1.68% for most clinicians and 1.19% for those in qualifying payment models ⁹.
3. Jul 15, 2026GOP Doctors Caucus leaders introduced the Patients First Act, H.R. 9693, to rewrite Medicare's doctor-pay formula ⁹.
4. Nov 4, 2026CMS released the final rule with deeper cuts: 2.31% and 1.83% ¹².
5. Jan 1, 2027The new payment rates take effect unless Congress acts ².

Free to reprint Republish this story on your site or in your newsletter

Any site, blog or newsletter may run this story free of charge. Keep the credit line and its link to the original, do not sell it, and edit only for length or house style (the full terms). Photos carry their own licenses, noted under each photo on this page, so use the text alone unless a credit says otherwise.

<h2>Trump&#39;s Medicare cuts most doctors&#39; pay 2.31% in 2027, deeper than first proposed</h2> <p><em>By The GOP Files Kitchen-Table Desk. This article first appeared on <a href="https://thegopfiles.com/story/trump-s-medicare-cuts-most-doctors-pay-2-31-in-2027-deeper-than-first-proposed">The GOP Files</a> on Thursday, November 5, 2026.</em></p> <p>On Wednesday, Nov. 4, the Trump administration released its final rule on what Medicare will pay doctors in 2027. The rule cuts the program&#39;s base payment rate for most doctors and other clinicians. It takes effect Jan. 1, 2027 .</p> <p>The rate is called the conversion factor. It is the dollar amount Medicare multiplies by each service&#39;s assigned value to set the fee. For most clinicians it falls from $33.40 to $32.63, a 2.31% cut. Clinicians in qualifying alternative payment models, which reward doctors for holding down costs and meeting quality goals, see a 1.83% cut, from $33.57 to $32.95 .</p> <p>Both cuts go deeper than the ones the Centers for Medicare &amp; Medicaid Services (CMS), the agency that runs Medicare, proposed in July. Those were 1.68% and 1.19% .</p> <h2>Why the pay is falling</h2> <p>Most of the cut comes from a temporary raise running out. Congress gave doctors a one-year, 2.5% increase for 2026 in Public Law 119-21, and that raise expires . Small increases required by law, 0.25% for most clinicians and 0.75% for those in qualifying payment models, make up only part of the loss .</p> <p>By law, Medicare&#39;s yearly doctor-pay updates must be budget neutral. That means more money for one service has to be balanced by less for others. Healthcare Dive reports that this has left Medicare doctor pay behind the rising cost of care, and that Congress usually steps in with higher rates before cuts take effect .</p> <p>CMS Administrator Dr. Mehmet Oz described the rule as a shift away from paying for volume .</p> <blockquote><p>For too long, fee-for-service payment has rewarded volume over value, fueling a reactive system of sick care</p><p>&mdash; Mehmet Oz, Administrator, Centers for Medicare &amp; Medicaid Services</p></blockquote> <p>&quot;This final rule breaks from that status quo,&quot; Oz said. Health and Human Services Secretary Robert F. Kennedy Jr. said &quot;Medicare should reward clinicians for keeping people healthy&quot; .</p> <h2>What changes at the doctor&#39;s office</h2> <p>Sometimes a patient gets an office visit and a minor procedure on the same day. Under the rule, Medicare will pay 20% less for the cheaper of the two. CMS first proposed a 50% cut and scaled it back after pushback from providers . Dermatology, ear-nose-and-throat care and podiatry are among the specialties facing the largest hits from the rule&#39;s payment changes .</p> <p>The rule lowers the value Medicare assigns to a surgeon&#39;s work on total hip and knee replacements, from 19.11 to 16.70 . The orthopaedic surgeons&#39; group said the cuts first proposed &quot;were reduced by nearly 50%&quot; .</p> <p>Some changes could help patients directly. Starting April 1, 2027, accountable care organizations (ACOs) approved by CMS may reduce or eliminate Part B cost-sharing for many services for patients assigned to them . ACOs are networks of doctors and hospitals that share in the savings when they hold down costs. Part B is the part of Medicare that covers doctor visits. Medical equipment and prescription drugs are excluded from the waiver .</p> <p>The rule also establishes payment pathways for health and well-being coaching and dedicated billing for shared medical appointments, and finalizes two new billing codes for advance care planning .</p> <p>Payments for regular office visits get a 16% boost through a new billing modifier, and a 32% boost for practitioners in shared savings program ACOs and LEAD model participant providers .</p> <h2>Home monitoring rules delayed</h2> <p>Remote patient monitoring sends readings, such as blood pressure, from a patient&#39;s home to the doctor. CMS wants only staff employed by the billing practice to provide these services, but it delayed that requirement to Jan. 1, 2029. Practitioners billing remote monitoring must furnish a separately reportable initiating visit when services begin, and a related therapy-monitoring service will be limited to established patients .</p> <p>Caroline Pearson of the Peterson Center on Healthcare called the monitoring changes &quot;a check against the rapid growth of these services&quot; .</p> <h2>Doctors&#39; groups turn to Congress</h2> <p>Physician groups criticized the rule right away .</p> <blockquote><p>further degrade an already fragile payment system</p><p>&mdash; Anders Gilberg, Senior vice president, Medical Group Management Association</p></blockquote> <p>The American Academy of Family Physicians said, &quot;Physicians will once again begin the year with lower rates as practice costs continue to rise&quot; . The Primary Care Collaborative said budget-neutrality rules mean across-the-board cuts on Jan. 1 unless Congress acts, and its president and CEO, Ann Greiner, urged Congress to address the cuts .</p> <p>The Medical Group Management Association wants Congress to fix the conversion factor and the same-day payment change immediately. It also backs comprehensive reform of Medicare&#39;s doctor-pay formula through the Patients First Act . That bill, H.R. 9693, was introduced July 15 by three physician lawmakers: Republican Reps. John Joyce of Pennsylvania and Greg Murphy of North Carolina, who co-lead the GOP Doctors Caucus, and Rep. Kim Schrier, D-Wash., who leads the Democratic Doctors Caucus .</p> <p>The pattern is familiar. In March 2025, Republicans passed a government funding bill with no fix for the doctor-pay cuts that had begun that January. Rep. Ami Bera, D-Calif., a physician, and five other Democratic doctors in the House warned that the cuts would &quot;further drive up costs for seniors&quot; .</p> <blockquote><p>Now the Republican majority has excluded any physician payment relief for the second time, and patients will pay the price.</p><p>&mdash; Ami Bera, U.S. representative, D-Calif., in a joint statement with five other Democratic physicians in the House (March 2025)</p></blockquote> <p>That matters because the timing is tight. The current Republican Congress has until the end of December to act before the cut lands. Democrats won both chambers on Tuesday . Medicare&#39;s open enrollment period, when seniors can change plans, runs through Dec. 7 .</p> <p><em>Read the original, with every source linked, at <a href="https://thegopfiles.com/story/trump-s-medicare-cuts-most-doctors-pay-2-31-in-2027-deeper-than-first-proposed">thegopfiles.com</a>. Republished under The GOP Files' <a href="https://thegopfiles.com/republish">free republishing terms</a>.</em></p> <img src="https://thegopfiles.com/api/rp/trump-s-medicare-cuts-most-doctors-pay-2-31-in-2027-deeper-than-first-proposed.gif" alt="" width="1" height="1" style="border:0;width:1px;height:1px">

Copy the HTML Paste it into your editor's HTML view. The one-pixel image at the end tells our newsroom the story ran; it stores no reader data.

Sources

1. CMS, “CMS Finalizes CY 2027 Physician Fee Schedule to Shift from Sick Care to Healthcare and Curb Waste” (2026-11-04). cms.gov/newsroom/press-releases/cms-finalizes-cy-2027-physic
2. CMS, “Calendar Year (CY) 2027 Medicare Physician Fee Schedule Final Rule (fact sheet)” (2026-11-04). cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-
3. Medical Economics, “Medicare's final 2027 fee schedule cuts physician pay more than proposed but softens the same-day visit penalty” (2026-11-04). medicaleconomics.com/view/medicare-s-final-2027-fee-schedule
4. Medical Economics, “Physician advocates urge Congress to counter cuts in final 2027 Medicare Physician Fee Schedule” (2026-11-05). medicaleconomics.com/view/physician-advocates-urge-congress-
5. Healthcare Dive (via Yahoo News), “Medicare finalizes physician pay cut for 2027” (2026-11-05). yahoo.com/news/politics/articles/medicare-finalizes-physicia
6. Chief Healthcare Executive, “CMS' final 2027 physician fee schedule cuts pay and reworks ACO incentives” (2026-11-04). chiefhealthcareexecutive.com/view/cms-final-2027-physician-f
7. AHA News, “CMS issues CY 2027 physician fee schedule final rule” (2026-11-04). aha.org/news/headline/2026-11-04-cms-issues-cy-2027-physicia
8. Office of Rep. Ami Bera, “Representative Bera, Democratic Doctors Call Out Congressional Republicans and the Trump Administration for Failing to Address Physician Fee Schedule Cuts” (2025-03-13). bera.house.gov/news/press-releases/representative-bera-democ
9. Medical Daily, “Congress Warms to Permanent Medicare Doctor Pay Overhaul, but Another Short-Term Patch Looks Likely Before January” (2026-09-25). medicaldaily.com/congress-medicare-doctor-pay-overhaul-2027-
10. National Committee to Preserve Social Security and Medicare, “In a Way, It's a Silver Tsunami, Too” (2026-11-04). ncpssm.org/entitledtoknow/in-a-way-its-a-silver-tsunami-too/
11. CMS, “CMS-1848-F (CY 2027 Physician Fee Schedule final rule)” (2026-11-04). cms.gov/medicare/payment/fee-schedules/physician/federal-reg

Found an error? Tell the newsroom. Corrections are noted at the top of the story.