Medicare Part B Cuts Proposed for 2027: What Patients Should Know

My phone rang last week from a woman who’d just gotten a letter from her orthopedic surgeon’s office saying they were “reassessing their Medicare participation.” She’d been seeing this doctor for two years for a knee replacement follow-up. She had no idea what was coming or why. I’ve seen this scenario play out before, and right now, in August 2026, it’s about to get more common.

Here’s what’s happening. On July 14, 2026, the Centers for Medicare & Medicaid Services (CMS, the federal agency that runs Medicare) released its proposed payment rule for 2027. It’s a nearly 1,600-page document that would cut what Medicare pays doctors for almost every type of visit and procedure. The comment period closes September 14, 2026. That’s not much time, and most beneficiaries don’t even know this is on the table.

The short version: a temporary 2.5% payment boost that Congress tucked into 2026 legislation called the Working Families Tax Cut Act (WFTCA) is about to expire. When it does, physician pay under Medicare Part B (the part that covers doctor visits, outpatient care, and preventive services) drops. That affects your care more directly than most people realize.

Why This Cut Is Happening Now

Medicare pays doctors using something called the conversion factor, a dollar amount multiplied by the complexity of each service to produce the payment. For 2026, that rate sits at $33.40. The CMS proposed rule for 2027 would drop it to $32.84, a cut of $0.56, or about 1.68%, according to the CMS Fact Sheet on the CY 2027 Medicare Physician Fee Schedule Proposed Rule.

That number might sound small. It isn’t, especially when stacked on years of payments that haven’t kept up with medical inflation. The American Medical Association has pointed out that Medicare physician payment has effectively lost about 33% of its purchasing power since 2001 when adjusted for practice costs. The 2.5% boost Congress passed in WFTCA was a one-year patch, not a permanent fix. When that patch expires at the end of 2026, CMS is required to reflect that reality in its proposed rule.

A House Energy and Commerce subcommittee took a hard look at long-term Medicare physician payment reform in May 2026, which tells you bipartisan frustration with this pattern of temporary fixes is real. But a fix hasn’t arrived yet, and the clock is running.

Which Specialties Are Hit Hardest

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Not every specialty feels this equally. The proposed rule contains sharp differences by specialty, and if your doctor happens to be in one of the harder-hit fields, you may notice changes sooner.

These figures come from the LeadingAge analysis of the proposed rule, published July 16, 2026. What most people don’t realize is that Medicare payments aren’t just about doctor income. When a specialty faces a large cut, some practices respond by capping the number of Medicare patients they accept, limiting access for everyone on Medicare in that community.

What This Means for Your Access to Care

The woman who called me about her orthopedic surgeon? Her situation is exactly the access problem these payment cuts create. A doctor can do one of three things under Medicare: accept “assignment” (meaning they agree to Medicare’s payment as full payment), become a non-participating provider (they can bill slightly higher but you pay more), or opt out entirely and operate outside Medicare altogether.

When payment rates drop sharply, the opt-out calculation changes. Practices in high-cost areas like major cities or medically underserved rural regions feel the squeeze most. Specialties like dermatology and orthopedic surgery, which have significant Medicare patient populations and high overhead costs, are particularly vulnerable.

Here’s what this means practically for you. If your dermatologist or orthopedic surgeon stops accepting Medicare assignment, your out-of-pocket costs can jump. If they opt out entirely, Medicare won’t cover their services at all, unless it’s an emergency. Checking whether your doctors are still participating providers is something I recommend doing at Medicare.gov’s Care Compare tool at least once a year, and now is a very good time.

This Is a Proposed Rule, Not a Final One

This matters. The rule released on July 14, 2026, is a proposal. CMS is legally required to accept public comments, and the window is open through September 14, 2026. Comments from beneficiaries carry real weight alongside those from medical associations and hospital systems. You can submit a comment at regulations.gov by searching for the CY 2027 Physician Fee Schedule Proposed Rule.

What should you say? Keep it personal and specific. If you depend on a specialist who’s facing a large cut, describe what it would mean if you lost access to that doctor. CMS staff read beneficiary comments differently than they read lobbying letters, and they do count.

Congress could also act before January 1, 2027. I’ve seen this movie before. Temporary patches get passed in late December more often than not. But relying on that is not a plan, and the May 2026 House subcommittee hearing suggests Congress is at least aware that the recurring patch-and-expire cycle isn’t working long term. Whether that awareness turns into permanent reform this year remains to be seen.

Steps You Can Take Right Now

You don’t need to wait for this to become final before taking action. A few things worth doing before September:

First, call your primary care doctor and any specialists you see regularly. Ask directly: “Are you planning to continue accepting Medicare in 2027?” A brief conversation now is far better than a surprise letter later.

Second, look up your doctors on Medicare.gov using the Care Compare tool (medicare.gov/care-compare). It shows current participation status, though it won’t yet reflect 2027 decisions.

Third, if you have a Medicare Supplement plan (also called Medigap), review what it covers in terms of excess charges, those are extra amounts a non-participating provider can charge above Medicare rates. Plan F and Plan G handle these differently. If you have Medicare Advantage (Part C, offered by private insurers approved by Medicare), check whether your plan’s network still includes your doctors. Advantage plans renegotiate with providers separately, so the fee schedule cut affects them indirectly but the network access risk is real.

Fourth, submit a comment at regulations.gov before September 14. It takes ten minutes and it matters.

The payment fight between Congress, CMS, and the medical community has been grinding along for decades. What’s different in 2026 is that the cumulative effect of years of below-inflation payments is pushing more practices toward a tipping point. I don’t say that to alarm you. I say it because knowing what’s coming is how you protect yourself. Talk to your doctors, check your coverage, and consider saying something to CMS before the window closes. A knowledgeable friend would tell you the same thing.

Sources

• CMS Fact Sheet: Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule (July 14, 2026)
• CMS Proposes Medicare Physician Pay Cuts for 2027 , Healthcare Finance News (July 2026)
• CY27 Physician Fee Schedule Proposed Rule , LeadingAge (July 16, 2026)
• CMS Issues CY 2027 Medicare Physician Fee Schedule Proposed Rule , Holland & Knight (July 2026)
• 2027 Medicare PFS: Key Changes and Payment Cuts , MDaudit (July 2026)

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This article is for informational purposes only. Medicare rules change annually. Always verify current plan details at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227). This site does not sell insurance or recommend specific plans.

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