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Effective January 1, 2027 · Final rule expected November 2026

Practice Pro · Medicare Billing Update

2027 Medicare Fee Schedule for Physical Therapy: What Changes and How to Prepare

The 2027 Medicare Physician Fee Schedule lowers the conversion factor, raises the KX threshold, tightens remote therapeutic monitoring and replaces CPT 92507. Here is what it means for PT, OT and SLP payment, with a free calculator and a January 1 checklist.

By the Practice Pro Billing & Compliance Team Updated Nov 2, 2026 12 min read
2027 Medicare fee schedule for physical therapy: what changes and how to prepare, including the conversion factor, KX threshold and new SLP codes
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Written by the Practice Pro Billing & Compliance Team, who build billing and RCM software for PT, OT and SLP practices and work Medicare claims every day. Based on the CY 2027 Physician Fee Schedule proposed rule (CMS-1848-P) and guidance from APTA and ASHA. Updated November 2, 2026. Not legal or billing advice.
Medicare billingPrimary CMS sourcesPT · OT · SLP

Status: The figures below are from the proposed rule. CMS usually publishes the final rule in early November (Oct 31 in 2025; Nov 1 in 2024). We will update this page the day it is released, and changes take effect January 1, 2027.

The Short Version

  • The proposed 2027 Medicare conversion factor is $32.8409 for most therapists, down 1.68% from $33.4009, because a one-year 2.5% increase for 2026 expires.
  • Even so, CMS projects therapy payments up roughly 1–3% overall, because practice-expense changes raise the value of many therapy codes.
  • The KX modifier threshold rises to $2,540 (PT and SLP combined; OT separate). Targeted medical review stays at $3,000.
  • Remote therapeutic monitoring would require an established patient, an initiating visit and directly employed staff.
  • PTs, OTs and SLPs can keep billing Medicare telehealth through December 31, 2027, and CPT 92507 is replaced by 92654–92663.

What Is the 2027 Medicare Physician Fee Schedule?

The 2027 Medicare Physician Fee Schedule (MPFS) sets how much Medicare Part B pays for every CPT code, including physical, occupational and speech therapy, for dates of service from January 1 to December 31, 2027. CMS released the proposed rule on July 14, 2026; the final rule is expected in November 2026.

Each code’s payment is its relative value units (work, practice expense and malpractice), adjusted for your locality, multiplied by the conversion factor. That means two things move a therapist’s Medicare payment each year: the conversion factor, which applies to every code, and the RVUs of the specific codes you bill. In 2027 they move in opposite directions.

2027 Medicare Changes for Physical Therapy at a Glance

Item20262027
Conversion factor, most therapists (non-QP)$33.4009$32.8409 (proposed, −1.68%)
Conversion factor, qualifying APM participants$33.5675$33.1693 (proposed, −1.19%)
Projected overall therapy payment—About +1% to +3% (CMS and APTA estimates)
KX threshold, PT + SLP combined$2,480$2,540 (proposed)
KX threshold, OT$2,480$2,540 (proposed)
Targeted medical review threshold$3,000$3,000
Remote therapeutic monitoringCurrent rulesEstablished patients, initiating visit, employed staff (proposed)
Medicare telehealth for PT, OT, SLPAllowedAllowed through Dec 31, 2027 (law)
Individual SLP treatmentCPT 92507CPT 92654–92663 (AMA CPT 2027)
PTA/OTA (CQ/CO) services85% of fee schedule85% of fee schedule

Proposed values from CMS-1848-P (91 FR 43842). Final values may differ.

The 2027 Medicare Conversion Factor, Explained

CMS proposes a 2027 conversion factor of $32.8409 for clinicians who are not qualifying APM participants, which includes most private-practice therapists. That is $0.56 (1.68%) lower than 2026. Qualifying APM participants would get $33.1693, down 1.19%.

The cut is mostly a math reset. Congress added a one-time 2.5% increase for 2026, and it ends on December 31, 2026. The 2027 figure includes the statutory updates (+0.25% for non-QPs, +0.75% for QPs) and a +0.53% budget-neutrality adjustment, but those don’t fully replace the expiring 2.5%. Congress could still act before January, as it has in past years, so watch the final rule.

Will Physical Therapy Medicare Payment Go Up or Down in 2027?

Despite the lower conversion factor, CMS projects a small overall increase for physical and occupational therapy in 2027. Analyses of CMS’s impact table put the increase at about 3% from RVU and practice-expense changes, or roughly +1.3% after the conversion factor cut; APTA describes it as 1–3%.

The reason is a proposed rewrite of how practice expense is calculated, which favors clinicians who work in offices rather than facilities. Therapy codes such as therapeutic activities, neuromuscular re-education, self-care and evaluations may move differently from each other, so your result depends on your code mix and locality.

  • Clinics heavy in timed treatment codes (97110, 97530, 97112, 97140) should model their own top codes once the final RVU files are posted.
  • Facility-based outpatient therapy may see a different effect than private practices.
  • Contracts tied to a percentage of Medicare will move automatically on January 1.

For current per-code amounts, see our physical therapy CPT codes and 2026 reimbursement rates.

2027 Medicare Payment Impact Calculator for Therapy Clinics

Enter your annual Medicare Part B therapy collections to see two scenarios: the conversion factor cut alone, and the projected net therapy change.

Estimate your 2027 Medicare therapy revenue

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Conversion-factor-only scenario uses $32.8409 ÷ $33.4009 (−1.68%). The default net change (+1.3%) reflects published analyses of CMS’s proposed impact table. Planning estimate only; your code mix, locality, MPPR and payer contracts change the result.

KX Modifier Threshold 2027: $2,540

CMS proposes a 2027 KX modifier threshold of $2,540 for physical therapy and speech-language pathology combined, and a separate $2,540 for occupational therapy, up from $2,480 (a 2.5% MEI update). The targeted medical review threshold stays at $3,000.

Once a patient’s allowed therapy charges for the year pass the threshold, every additional line needs the KX modifier and documentation of medical necessity, or the claim denies. With the review threshold unchanged, the gap between KX and targeted review narrows to $460. Read our full KX modifier guide.

Remote Therapeutic Monitoring Changes for 2027

CMS proposes three new conditions for remote therapeutic monitoring (RTM) in 2027: RTM would be limited to established patients, the practitioner would need to furnish a separately reportable initiating visit, and the clinical staff time billed must come from staff directly employed by the practice, not outside contractors.

Clinics that outsource RTM monitoring to a vendor should review the model before January. The 2026 RTM codes (98979, 98984, 98985) that allowed shorter monitoring periods remain part of the code set. See our remote therapeutic monitoring overview.

Medicare Telehealth for PTs, OTs and SLPs Through 2027

Physical therapists, occupational therapists and speech-language pathologists can continue to bill Medicare for telehealth services through December 31, 2027, under the Consolidated Appropriations Act, 2026. The 2027 fee schedule carries that extension into Medicare regulations.

Telehealth visits still need the right place-of-service code and modifiers for the payer, and the same documentation as an in-person visit.

2027 Speech Therapy Codes: CPT 92507 Is Replaced

On January 1, 2027, CPT 92507 is deleted and replaced by ten timed speech-language treatment codes, 92654 through 92663: a 30-minute base code and a 15-minute add-on in five clinical categories. CMS proposed Medicare payment values for all ten in the 2027 rule.

SLP clinics need new templates, minute tracking and fee schedules before January. See our full guide to the new speech therapy CPT codes for 2027, with a code calculator.

What Stays the Same in 2027

  • The 8-minute rule for timed codes. See our Medicare 8-minute rule guide.
  • GP, GO and GN modifiers on every therapy line.
  • CQ and CO services by assistants paid at 85% of the fee schedule.
  • Multiple procedure payment reduction on the practice expense of additional “always therapy” units.
  • Plan-of-care certification within 30 days, recertification at least every 90 days, and progress reports every 10 treatment days.

2027 Medicare Readiness Checklist for Therapy Clinics

  • Load the final 2027 fee schedule and update expected-payment amounts by payer.
  • Set KX alerts at $2,540 (PT + SLP) and $2,540 (OT) once final.
  • Review RTM: established patients, initiating visit, employed staff.
  • Build SLP templates and charge codes for 92654–92663; retire 92507 for 2027 dates of service.
  • Confirm telehealth place-of-service and modifier rules for each payer.
  • Recheck commercial and Medicare Advantage contracts priced as a percentage of Medicare.
  • Model your top 10 CPT codes against the final RVUs and update your 2027 budget.
  • Train billers and therapists before the first January claims go out.

How Physical Therapy Billing Software Handles the 2027 Changes

Most 2027 changes land in the billing system: new rates, a new KX threshold, new SLP codes and new RTM rules. When documentation and billing share one record, the minutes in a signed note become the right codes, units and modifiers automatically, and KX alerts fire before a claim is sent.

Practice Pro’s billing and RCM runs on the same record as its PT, OT and SLP documentation, with an optional RCM team that can work your 2027 transition with you. Comparing systems before January? See the best physical therapy EMR software comparison.

2027 Medicare Fee Schedule for Physical Therapy: FAQs

CMS proposes a 2027 conversion factor of $32.8409 for clinicians who are not qualifying APM participants, which includes most physical therapists, down 1.68% from $33.4009 in 2026. Qualifying APM participants would get $33.1693. Final figures come with the final rule in November 2026.

Not necessarily. The conversion factor falls 1.68%, but CMS projects a small overall increase for physical and occupational therapy, roughly 1–3%, because proposed practice-expense changes raise the value of many therapy codes. Your result depends on your code mix and locality.

The 2027 Medicare Physician Fee Schedule applies to dates of service from January 1, 2027. CMS released the proposed rule on July 14, 2026 and usually publishes the final rule in early November.

As of November 2, 2026, the 2027 figures are proposed. CMS is expected to publish the final rule in November 2026, and this page will be updated when it does.

CMS proposes a 2027 KX modifier threshold of $2,540 for physical therapy and speech-language pathology combined and a separate $2,540 for occupational therapy, up from $2,480. The targeted medical review threshold stays at $3,000.

Congress added a one-time 2.5% increase to the conversion factor for 2026, and it expires on December 31, 2026. The 2027 statutory updates and a budget-neutrality adjustment don’t fully replace it, so the conversion factor falls.

CMS proposes limiting RTM to established patients, requiring a separately reportable initiating visit, and paying only when the clinical staff time comes from staff directly employed by the practice rather than contractors.

Yes. Physical therapists, occupational therapists and speech-language pathologists can bill Medicare telehealth through December 31, 2027, under the Consolidated Appropriations Act, 2026.

CPT 92507 is replaced on January 1, 2027 by ten timed speech-language treatment codes, 92654 through 92663, with a 30-minute base code and 15-minute add-on in five clinical categories. See our 2027 speech therapy CPT codes guide.

No. The Medicare 8-minute rule for timed therapy codes stays the same in 2027: 8–22 minutes is one unit, 23–37 is two, and so on, based on total timed minutes.

Yes. Services furnished in whole or in part by a physical therapist assistant or occupational therapy assistant, billed with the CQ or CO modifier, continue to be paid at 85% of the fee schedule amount.

CMS hasn’t published final 2027 payment amounts yet. In 2026, the national non-facility amount for 97110 is about $29.06. The 2027 amount will reflect the new conversion factor and any RVU changes in the final rule.

Load the final fee schedule, update KX alerts to $2,540, review RTM workflows, build SLP templates for codes 92654–92663, confirm telehealth billing rules, recheck contracts tied to Medicare rates and train billers before the first January claims.

Billing software connected to the EMR updates rates, applies the new KX threshold, maps new SLP codes and checks claims before submission. Practice Pro does this on one record for PT, OT and SLP, with an optional RCM team.

Sources & references

  1. CMS, CY 2027 Physician Fee Schedule proposed rule (CMS-1848-P), Federal Register, July 16, 2026 (91 FR 43842).
  2. American Hospital Association and Holland & Knight summaries of the CY 2027 PFS proposed rule (conversion factors, KX threshold), July 2026.
  3. APTA, “Proposed 2027 Medicare Physician Fee Schedule: What PTs Need to Know,” Parts 1 and 2, July–August 2026.
  4. WebPT, “The 2027 Proposed Rule Is Out” (APTQI estimate of ~1.3% net therapy update), 2026.
  5. ASHA, “New Speech-Language Pathology Treatment Codes Replacing 92507.”
  6. Consolidated Appropriations Act, 2026: Medicare telehealth flexibilities through December 31, 2027.

CPT® is a registered trademark of the American Medical Association. This page summarizes public rules for education and is not legal or billing advice. Proposed values may change in the final rule.

Get Ready for January 1, 2027

New rates, a new KX threshold and new SLP codes. See how Practice Pro handles PT, OT and SLP billing on one record, with an RCM team ready to help with the 2027 switch.