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Home > Curriculum > Medicare & Compliance Changes: Regulatory Update

Medicare & Compliance Changes: Regulatory Update

Essential Updates for Compliance, Billing, & Revenue Cycle Leaders

The Centers for Medicare & Medicaid Services (CMS) released the finalized Calendar Year (CY) 2027 Physician Fee Schedule (PFS) on November 4, 2026. Taking effect on January 1, 2027, this major rule introduces sweeping updates to payment policies, billing rules, and quality-related provisions for physician services furnished under Medicare Part B.

This course provides an up-to-the-minute, post-release analysis of the final regulations. Learn the exact provider reimbursement and compliance reporting requirements your practice must implement immediately to protect its revenue cycle.

You don’t have to navigate the complex CMS rulemaking alone. PMI’s healthcare practice compliance and revenue cycle management experts will share meaningful insights on the operational impact of the finalized rule for 2027. Attend this session to gain direct answers to your complex regulatory questions and receive critical, actionable execution tips.

Key 2027 Financial & Compliance Impacts We Will Cover:

  • CMS Retires HCPCS Code G2211: Master the transition of G2211 from a standalone add-on code into two distinct billing modifiers that apply a percentage-based payment bump rather than a flat rate.
  • CY 2027 Finalized Conversion Factors: Calculate the bottom-line impact of the finalized payment reductions, including the $32.63 non-APM conversion factor (a 2.31% drop) and the $32.95 qualifying APM factor.
  • Two New Advance Care Planning (ACP) Codes: Unpack the finalized implementation, documentation parameters, and billing rules for the two brand-new ACP codes.
  • 340B Part D Reporting Grace Period: Navigate the newly finalized mandate for submitting Medicare Part D claims data to the CMS 340B Repository.
  • Remote Monitoring Guardrails: Navigate new compliance mandates, including the mandatory initiating visit requirement for RPM/RTM, new established-patient rules, and the delay on the third-party vendor staff ban.
  • Same-Day Modifier 25 Reductions: Unpack the finalized policy that implements a strict payment reduction when an office E/M service is billed with modifier 25 alongside a 0-day global procedure.
  • Telehealth Flexibilities & Modifiers: Review the finalized regulations aligning with the congressional extension of home-based telehealth flexibilities through December 2027, along with newly created billing modifiers for 2027.
  • MIPS Sunset Timeline: Understand the final timeline shifting traditional MIPS to MIPS Value Pathways (MVPs) by the 2031 performance period and the mandatory "Core Measure" reporting required starting in 2027.
  • OIG Work Plan: Highlights of the latest OIG audit and evaluation projects targeting modifier usage and digital health services.

Give your team a head start on strategic planning, financial forecasting, and compliance mapping for 2027. Healthcare practices must be prepared. The cumulative effect of the finalized dual conversion factors, budget neutrality adjustments, and specialty-specific modifier penalties will vary, but the overall impact on practice cash flow will be significant.

 

This course assumes a foundational understanding of the healthcare regulatory environment. Digital companion materials will be provided with helpful resources and links for use beyond the classroom. 

 

Who Should Attend?

  • Practice Managers & Administrators: Protect your cash flow by auditing 2027 fee schedules and updating provider productivity models early against the dual-conversion factor framework.
  • Medical Billers & Coders: Avoid claim denials by mastering the new modifier transition for complexity and the modifier 25 pay cuts.
  • Compliance Officers & Chart Auditors: Pinpoint target risk areas in your E/M and remote monitoring documentation to prevent costly retrospective recoupments.

Continuing Education Units (CEUs)

PMI CEU Approved Earn 3 PMI CEUs for attendance at this program. Practice Management Institute grants CEUs for its certified professionals based on the total number of instructional hours, with one CEU granted per hour of classroom instruction. CEUs may be applied to annual recertification requirements, as directed in the certification renewal requirements for your credential or credentials.

If you are seeking CEU credits for other certifications or organizations, please contact your organization for pre-approval and credit guidelines. A certificate of attendance will be provided.

110926 MCC

Program Schedule

Location Date / Time Register
MCALLEN, TX 12-02-2026 9:00 AM - 12:00 PM
WEBINAR 12-02-2026 9:00 AM - 12:00 PM
KEARNEY, NE 12-09-2026 9:00 AM - 12:00 PM
LINCOLN, NE 12-10-2026 9:00 AM - 12:00 PM
WEBINAR 12-16-2026 11:00 AM - 2:00 PM
WEBINAR 01-13-2027 11:00 AM - 2:00 PM
MCALLEN, TX 12-07-2027 9:00 AM - 12:00 PM
KEARNEY, NE 12-08-2027 9:00 AM - 12:00 PM
LINCOLN, NE 12-09-2027 9:00 AM - 12:00 PM
WEBINAR 12-14-2027 11:00 AM - 2:00 PM

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