AAFP Welcomes Primary Care Gains in 2027 Medicare Rule, Warns Payment Cuts Threaten Access

FOR IMMEDIATE RELEASE: November 4, 2026

Media Contact:
AAFP Public Relations
pr@aafp.org​

Washington, D.C. – The American Academy of Family Physicians (AAFP) welcomes several primary care improvements in the Centers for Medicare & Medicaid Services' (CMS) final 2027 Medicare physician fee schedule. However, lower physician payment rates and a new cut to certain same-day services could make it harder for Medicare patients to get the comprehensive care they need.

CMS finalized an expansion of the Primary Care Exception, a change that family physicians have sought for years. When clinically appropriate, qualifying residents will be able to provide more complex office and outpatient care without a teaching physician in the room. This change will give residents additional experience caring for complex Medicare patients as they prepare for independent practice.

We are also encouraged that CMS will expand Medicare recognition of and payment for more comprehensive primary care services, including shared medical appointments, maternity care, tobacco cessation and advance care planning.

At the same time, the rule continues a troubling pattern of inadequate Medicare physician payment. The 2027 conversion factors—the base rates used to calculate physician payment—are $32.9548 for qualifying participants in advanced payment models and $32.6286 for other clinicians. That is 1.83% and 2.31% lower, respectively, than in 2026. The reductions are driven in part by the expiration of the temporary 2.5% payment increase Congress provided for 2026. This means that physicians will once again begin the year with lower rates as practice costs continue to rise. 

To that end, the AAFP urges Congress to pass legislation that would give physicians a reliable, annual payment update tied to inflation, such as the Strengthening Medicare for Patients and Providers Act and the Patients First Act. The latter legislation also proposes necessary structural reforms to Medicare physician payment that Congress must prioritize to preserve patient access to care, including changes to budget neutrality requirements and increased investments in primary care.

The AAFP also strongly opposes CMS’ decision to cut payment when a physician provides an office visit and a procedure on the same day. Under the policy, CMS will pay for the higher-cost service in full but will reduce payment for the additional service by 20%. This penalizes family physicians for addressing multiple health needs in one visit and could delay care or push patients to more expensive settings.

The AAFP appreciates the steps CMS and Congress have taken to better recognize the value of primary care. However, ensuring Medicare patients can continue to access that care requires concrete payment reform that allows practices to keep their doors open.

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About the American Academy of Family Physicians
The AAFP is the largest national association of family physicians, representing 124,500 physicians and medical students. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on impactful care for people of all ages, races and genders across all medical conditions. The AAFP supports every stage of a family physician's career and provides evidence-based resources, advocacy and community to empower family medicine. To learn more, visit AAFP.org. For information about health care, medical conditions and wellness, please visit the AAFP’s patient education website, FamilyDoctor.org​.