ACC releases calculator for payments based on 2027 Medicare physician fee schedule
The American College of Cardiology (ACC) created a 2027 Medicare Physician Fee Schedule (PFS) calculator so clinicians and practice managers can estimate the potential impact of payment changes to their practices.
The Centers for Medicare and Medicaid Services (CMS) released the 2027 2027 Medicare Physician Fee Schedule proposed rule July 14. ACC said the conversion factor decreased from $33.5675 to $33.1693 for qualifying alternative payment model (APM) participants, and from $33.4009 to $32.8409 for non-qualifying APM participants.
The ACC created the downloadable calculator to help practices and cardiologists estimate the potential impact of changes to their practices.
Cardiologists and their practices are paid by Medicare based on relative value units (RVUs) based on the time and resources needed to do the work (wRVU), along with practice expenses (PE RVU) and practice liability insurance (PLI RVU). Medicare also adjusts pay based on the Geographic Practice Cost Index (GPCI), which pays different rates for the same procedures depending on where the practice is located due to higher expenses in some regions.
Lastly, the above RVU calculations and then all multiplied by the Medicare conversion factor (CF) to calculate the actual dollar amount Medicare pays for each unit of value set by federal policy makers each year.
"When it goes down, payments go down, even if clinicians do the exact same work," explained Edward Robert Tuohy IV, MD, FACC, FSCAI, director of the cardiac cath lab at Bridgeport Hospital in Connecticut, who explained the calculator equations in an ACC video to members published July 30. "Small policy changes can have a big impact; that's why physician understanding and engagement is critically important."
ACC said overall reimbursement for cardiovascular services is projected to increase by about 1% compared with 2026. However, individuals and groups will see different amounts depending on the patient populations they serve and the services they offer.
The calculator comes as a downloadable spreadsheet that has five tabs. These include directions, CPT codes with descriptions for all procedures, a comparison of the 2026 and 2027 fee schedules, a list of the GPCIs for all Medicare administrative contractor MAC locations, and RVUs used in both the 2026 and 2027 fee schedules for comparisons.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]