Medicare change intelligence

What changed, and when

A timeline of material Medicare payment and billing changes—organized by the date they took effect, with the codes and rate releases behind each one.

Rate change marks a release that moved payment amounts for widely billed codes. High impact marks a reviewed billing change affecting 5 or more codes—breadth, not estimated dollars.

Planning ahead 2027 proposed rule

Changes that may arrive next

Follow the proposed conversion factors, same-day E/M reduction, G2211 replacement, and remote-monitoring rules as they move toward a final rule.

View 2027 outlook

Effective-date timeline

Material changes

Newest first · reviewed evidence and priced releases

Jan 1, 2026 Took effect
Rate change All 73 most-billed codes moved

The CY2026 fee schedule took effect

A new conversion factor repriced every payable code.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $32.3465 to $33.4009 (+3.26% increase ), repricing every payable code.

Most-billed codes tracked

73

Paid more

60

Paid less

13

Median move

+4.4% increase
Furthest movers among them

43239 #84 $357.11 → $418.85 +17.3% increase

99291 #23 $265.56 → $308.96 +16.3% increase

45380 #76 $414.68 → $479.97 +15.7% increase

45385 #44 $435.38 → $500.01 +14.8% increase

63650 #88 $2,127.11 → $2,388.50 +12.3% increase

64483 #94 $236.13 → $264.87 +12.2% increase
The 100 most-billed codes by 2024 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q1 2026 rate comparison
Jan 1, 2025 Took effect
Rate change High impact 10 codes affected

G2211 gained a limited modifier 25 exception

Medicare began allowing G2211 with a qualifying office/outpatient E/M base code, 99202-99205 or 99211-99215, with modifier 25 when an annual wellness visit, vaccine administration, or another CMS-listed eligible Part B preventive service is also furnished on the same date in the office or outpatient setting.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $33.2875 to $32.3465 (-2.83% decrease ), repricing every payable code.

Most-billed codes tracked

74

Paid more

3

Paid less

71

Median move

-2.8% decrease
Furthest movers among them

92134 #46 $40.28 → $31.38 -22.1% decrease

92133 #75 $36.28 → $29.76 -18.0% decrease

93229 #61 $812.88 → $744.62 -8.4% decrease

37229 #93 $8,694.36 → $8,070.45 -7.2% decrease

63650 #88 $2,273.54 → $2,127.11 -6.4% decrease

97530 #21 $36.62 → $34.61 -5.5% decrease
The 100 most-billed codes by 2024 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
Affected codes 99202 99203 99204 99205 99211 99212 99213 99214 +2 more
See the Q1 2025 rate comparison
Jan 1, 2024 Took effect
Rate change High impact 10 codes affected

G2211 became separately payable

Medicare began paying G2211 in addition to qualifying office/outpatient E/M base visits, codes 99202-99205 and 99211-99215. At launch, G2211 was not payable when the base visit carried modifier 25.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $33.8872 to $33.2875 (-1.77% decrease ), repricing every payable code.

Most-billed codes tracked

74

Paid more

8

Paid less

66

Median move

-1.3% decrease
Furthest movers among them

63685 #66 $367.34 → $342.20 -6.8% decrease

37229 #93 $9,102.44 → $8,694.36 -4.5% decrease

93229 #61 $849.55 → $812.88 -4.3% decrease

74177 #64 $322.61 → $310.91 -3.6% decrease

90837 #29 $147.07 → $152.12 +3.4% increase

90834 #79 $99.97 → $103.19 +3.2% increase
The 100 most-billed codes by 2024 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
Affected codes 99202 99203 99204 99205 99211 99212 99213 99214 +2 more
See the Q1 2024 rate comparison
Jan 1, 2023 Took effect
Rate change All 75 most-billed codes moved

The CY2023 fee schedule took effect

A new conversion factor repriced every payable code.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $34.6062 to $33.8872 (-2.08% decrease ), repricing every payable code.

Most-billed codes tracked

75

Paid more

11

Paid less

64

Median move

-1.2% decrease
Furthest movers among them

99231 #99 $38.76 → $49.81 +28.5% increase

99309 #19 $90.67 → $106.74 +17.7% increase

99233 #6 $102.43 → $119.28 +16.5% increase

99310 #83 $133.58 → $153.51 +14.9% increase

99223 #13 $198.29 → $173.84 -12.3% decrease

99232 #4 $71.29 → $79.30 +11.2% increase
The 100 most-billed codes by 2023 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q1 2023 rate comparison
Jan 1, 2022 Took effect
Rate change 74 of 76 most-billed codes moved

The CY2022 fee schedule took effect

A new conversion factor repriced every payable code.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $34.8931 to $34.6062 (-0.82% decrease ), repricing every payable code.

Most-billed codes tracked

76

Paid more

18

Paid less

56

Median move

-0.6% decrease
Furthest movers among them

99490 #73 $41.17 → $64.02 +55.5% increase

93229 #58 $717.05 → $911.87 +27.2% increase

37229 #74 $11,021.33 → $9,668.63 -12.3% decrease

63650 #90 $2,319.34 → $2,449.43 +5.6% increase

96413 #98 $148.30 → $140.16 -5.5% decrease

92250 #63 $39.78 → $37.72 -5.2% decrease
The 100 most-billed codes by 2022 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q1 2022 rate comparison
Jan 1, 2021 Took effect
Rate change High impact 10 codes affected · 10 reviewed changes

G2211 became reportable, but remained bundled

For qualifying longitudinal-care visits, G2211 could be reported with any new- or established-patient office/outpatient visit level, 99202-99205 or 99211-99215. Medicare assigned it bundled status, so it did not produce separate payment.

Office-visit level selection changed

Starting in 2021, office/outpatient visit levels 2 through 5 are selected using either medical decision making or total practitioner time on the encounter date. History and examination remain medically appropriate parts of the visit, but no longer determine its level.
Show 8 additional code-specific changes ↓ Hide additional changes ↑
- The 10-19 minute time range took effect
- The 15-29 minute time range took effect
- The 20-29 minute time range took effect
- The 30-39 minute time range took effect
- The 30-44 minute time range took effect
- The 40-54 minute time range took effect
- The 45-59 minute time range took effect
- The 60-74 minute time range took effect
Rate movement
National office (non-facility) amounts

The conversion factor moved from $36.0896 to $34.8931 (-3.32% decrease ), repricing every payable code.

Most-billed codes tracked

76

Paid more

39

Paid less

36

Median move

+0.1% increase
Furthest movers among them

90960 #37 $291.24 → $362.54 +24.5% increase

99215 #12 $148.33 → $183.19 +23.5% increase

99212 #26 $46.19 → $56.88 +23.1% increase

99442 #87 $76.15 → $92.82 +21.9% increase

99213 #2 $76.15 → $92.47 +21.4% increase

99443 #85 $110.43 → $131.55 +19.1% increase
The 100 most-billed codes by 2021 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
Affected codes 99202 99203 99204 99205 99211 99212 99213 99214 +2 more
See the Q1 2021 rate comparison
Jan 1, 2020 Took effect
Rate change 75 of 76 most-billed codes moved

The CY2020 fee schedule took effect

A new conversion factor repriced every payable code.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $36.0391 to $36.0896 (+0.14% increase ), repricing every payable code.

Most-billed codes tracked

76

Paid more

48

Paid less

27

Median move

+0.2% increase
Furthest movers among them

66984 #9 $654.47 → $557.58 -14.8% decrease

96372 #72 $16.94 → $14.44 -14.8% decrease

92250 #68 $51.54 → $45.83 -11.1% decrease

73030 #96 $30.63 → $33.56 +9.6% increase

37227 #86 $16,033.80 → $14,891.29 -7.1% decrease

37225 #84 $12,443.94 → $11,581.87 -6.9% decrease
The 100 most-billed codes by 2020 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q1 2020 rate comparison
Jan 1, 2019 Took effect
Rate change 75 of 76 most-billed codes moved

The CY2019 fee schedule took effect

A new conversion factor repriced every payable code.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $35.9996 to $36.0391 (+0.11% increase ), repricing every payable code.

Most-billed codes tracked

76

Paid more

39

Paid less

36

Median move

+0.1% increase
Furthest movers among them

96372 #65 $20.88 → $16.94 -18.9% decrease

37229 #70 $10,975.92 → $12,450.79 +13.4% increase

71045 #32 $22.32 → $25.23 +13.0% increase

37225 #73 $11,130.36 → $12,443.94 +11.8% increase

92250 #67 $58.32 → $51.54 -11.6% decrease

17003 #61 $5.40 → $5.77 +6.9% increase
The 100 most-billed codes by 2019 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q1 2019 rate comparison
Jul 1, 2018 Took effect
Rate change 1 of 78 most-billed codes moved

The Q3 2018 rate update took effect

Revised RVUs changed what 2 codes pay, with no change to the conversion factor.
Rate movement
National office (non-facility) amounts

The conversion factor held at $35.9996, so the movement came from revised RVUs on 2 codes.

Most-billed codes tracked

78

Paid more

1

Paid less

0

Median move

0.0% no change
Furthest movers among them

71045 #31 $20.16 → $22.32 +10.7% increase
The 100 most-billed codes by 2018 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q3 2018 rate comparison
Jan 1, 2018 Took effect
Rate change All 75 most-billed codes moved

The CY2018 fee schedule took effect

A new conversion factor repriced every payable code.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $35.8887 to $35.9996 (+0.31% increase ), repricing every payable code.

Most-billed codes tracked

75

Paid more

66

Paid less

9

Median move

+0.7% increase
Furthest movers among them

96372 #63 $25.84 → $20.88 -19.2% decrease

97530 #36 $35.53 → $41.40 +16.5% increase

92250 #68 $66.75 → $58.32 -12.6% decrease

93306 #25 $231.48 → $213.84 -7.6% decrease

97140 #34 $30.51 → $28.44 -6.8% decrease

17003 #65 $5.74 → $5.40 -5.9% decrease
The 100 most-billed codes by 2018 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q1 2018 rate comparison
Jan 1, 2017 Took effect
Rate change 72 of 75 most-billed codes moved

The CY2017 fee schedule took effect

A new conversion factor repriced every payable code.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $35.8043 to $35.8887 (+0.24% increase ), repricing every payable code.

Most-billed codes tracked

75

Paid more

61

Paid less

11

Median move

+0.5% increase
Furthest movers among them

92250 #69 $79.49 → $66.75 -16.0% decrease

92133 #79 $44.40 → $38.04 -14.3% decrease

43239 #64 $403.87 → $349.20 -13.5% decrease

45380 #59 $476.56 → $412.72 -13.4% decrease

45385 #46 $499.83 → $433.89 -13.2% decrease

92134 #60 $45.47 → $41.63 -8.4% decrease
The 100 most-billed codes by 2017 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q1 2017 rate comparison
Jan 1, 2016 Took effect
Rate change 69 of 75 most-billed codes moved

The CY2016 fee schedule took effect

A new conversion factor repriced every payable code.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $35.9335 to $35.8043 (-0.36% decrease ), repricing every payable code.

Most-billed codes tracked

75

Paid more

17

Paid less

52

Median move

-0.4% decrease
Furthest movers among them

77052 #32 $8.98 → $8.23 -8.4% decrease

45385 #49 $534.69 → $499.83 -6.5% decrease

43239 #52 $412.52 → $403.87 -2.1% decrease

99238 #78 $74.02 → $73.04 -1.3% decrease

99212 #26 $44.20 → $43.68 -1.2% decrease

88305 #22 $73.30 → $74.11 +1.1% increase
The 100 most-billed codes by 2016 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q1 2016 rate comparison
Oct 1, 2015 Took effect
Rate change All 75 most-billed codes moved

The Q4 2015 rate update took effect

A new conversion factor repriced every payable code.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $35.7547 to $35.9335 (+0.50% increase ), repricing every payable code.

Most-billed codes tracked

75

Paid more

75

Paid less

0

Median move

+0.5% increase
Furthest movers among them

11100 #67 $104.40 → $104.93 +0.5% increase

11721 #59 $45.05 → $45.28 +0.5% increase

17000 #46 $66.86 → $67.20 +0.5% increase

17003 #64 $5.72 → $5.75 +0.5% increase

17110 #98 $111.55 → $112.11 +0.5% increase

17311 #49 $666.11 → $669.44 +0.5% increase
The 100 most-billed codes by 2015 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q4 2015 rate comparison
Jan 1, 2015 Took effect
Rate change All 75 most-billed codes moved

The CY2015 fee schedule took effect

A new conversion factor repriced every payable code.
Rate movement
National office (non-facility) amounts

The conversion factor moved from $35.8228 to $35.7547 (-0.19% decrease ), repricing every payable code.

Most-billed codes tracked

75

Paid more

35

Paid less

40

Median move

-0.2% decrease
Furthest movers among them

17003 #64 $10.03 → $5.72 -43.0% decrease

77080 #84 $49.44 → $41.48 -16.1% decrease

77052 #32 $10.39 → $8.94 -14.0% decrease

17000 #46 $75.23 → $66.86 -11.1% decrease

71020 #16 $31.17 → $27.89 -10.5% decrease

73030 #95 $31.88 → $28.96 -9.2% decrease
The 100 most-billed codes by 2015 CMS utilization. Codes that aren't separately payable in both releases are left out of the comparison rather than shown as a move.
See the Q1 2015 rate comparison

Every quarterly comparison

Rate release archive

Every release compared against the quarter before it. Most quarters reprice nothing—CMS resets payment amounts each January and spends the rest of the year adding codes and correcting statuses—so the quiet ones are dimmed here.

What changed, and when

Changes that may arrive next

Material changes

The CY2026 fee schedule took effect

Rate movement

G2211 gained a limited modifier 25 exception

Rate movement

G2211 became separately payable

Rate movement

The CY2023 fee schedule took effect

Rate movement

The CY2022 fee schedule took effect

Rate movement

G2211 became reportable, but remained bundled

Office-visit level selection changed

Rate movement

The CY2020 fee schedule took effect

Rate movement

The CY2019 fee schedule took effect

Rate movement

The Q3 2018 rate update took effect

Rate movement

The CY2018 fee schedule took effect

Rate movement

The CY2017 fee schedule took effect

Rate movement

The CY2016 fee schedule took effect

Rate movement

The Q4 2015 rate update took effect

Rate movement

The CY2015 fee schedule took effect

Rate movement

Rate release archive

2026

2025

2024

2023

2022

2021

2020

2019

2018

2017

2016

2015

2014