Medicare Fee Schedule Proposal: Comment Deadline for Providers
Key Takeaways
The Health and Human Services Department published a proposed rule at 91 FR 43842 covering the physician fee schedule and other Medicare Part B payment policies. Nothing in it is in force. Comments must be received by September 14, 2026 — the date the rulemaking record closes, not a compliance date. It reaches physician practices, their billing teams, and their vendors. Federal Register
| Agency | Citation | RIN | Document type | Comment deadline |
|---|---|---|---|---|
| Health and Human Services Department | 91 FR 43842 | 0938-AV82 | Proposed rule | September 14, 2026 |
Read the deadline in that table as the day the record shuts, not the day anything begins. A proposed rule is a question the agency is asking. It can be withdrawn, reproposed, or issued in a different form, and the comment period itself can be reopened or extended.
What is on the table in this proposal
This brief is deliberately narrow. The document at 91 FR 43842 is an omnibus proposal, and each item below is described only as something the agency has put out for comment. This page carries no payment rates, conversion factors, relative value units, or budget-neutrality arithmetic; a practice that needs a number should read the Federal Register document, which is the controlling text.
The proposal's own abstract names these subjects:
The physician fee schedule. Changes to the schedule are proposed.
Other Medicare Part B payment policies. Proposed to reflect changes in medical practice, the relative value of services, and changes in the statute.
The Medicare Prescription Drug Inflation Rebate Program. Codification and establishment of new policies under the Inflation Reduction Act of 2022 are proposed.
The Ambulatory Specialty Model. Named in the abstract as a subject of the proposal.
Drugs and biological products paid under Part B. Updates are proposed.
Medicare Shared Savings Program requirements. Proposed updates. This page is not a Shared Savings Program explainer; the item appears here because it sits inside the same comment window.
The Quality Payment Program. Proposed updates.
Rural Health Clinics and Federally Qualified Health Centers. Proposed updates to their policies.
The Ambulance Fee Schedule regulations. An update is proposed.
Inflation Reduction Act and Consolidated Appropriations Act, 2026 provisions. Codification is proposed.
Clinical Laboratory Fee Schedule regulations. Proposed updates.
The Medicare Promoting Interoperability Program. Proposed updates.
Every one of those is a candidate change, described in the proposal's abstract in the Federal Register. None of them has been adopted, and none of them carries a date on which a practice would have to do anything differently.
That distinction is the whole point of the page. An omnibus proposal touches a lot of surface area at once, which makes it easy for a practice to skim the item list, decide it looks familiar, and file it. The cost of doing that is not a penalty — it is the lost chance to say something while the record is still open.
Which practices and vendors this reaches
The reader this brief is written for is a physician practice: an administrator, a group-practice compliance owner, a billing or revenue-cycle manager, and the person who owns Quality Payment Program reporting. The item list above is drawn from a proposal about physician payment, so the operational weight sits with practices rather than with hospitals or health plans.
Inside a practice, the surface area splits along existing lines. Billing and coding staff would absorb anything that changes how Part B services are described or valued. A reporting lead would absorb Quality Payment Program updates. Rural Health Clinic and Federally Qualified Health Center operations would absorb the items named for them. A practice that bills ambulance services would absorb the Ambulance Fee Schedule item, and a practice that dispenses or bills Part B drugs would absorb the drug and rebate items.
Billing and revenue-cycle vendors sit in the same window. A vendor operates the workflow on the practice's behalf, which means a proposed change to a payment policy is a change to the vendor's configuration, its edits, and its reporting output. Vendors often see the operational consequence of a proposal earlier than the practices they serve, and a comment from that vantage point is worth writing down.
None of this is a statement that any particular practice is in scope for any particular item. Scope questions belong to the practice's own compliance owner and to a qualified professional reading the primary text. Separately, Medicare program oversight is a different subject with its own brief, and this page does not restate it.
What is open for comment, part by part
The proposal is scoped to a set of parts in title 42 of the Code of Federal Regulations. Listing them, rather than summarising them, is the honest move: the current text at eCFR title 42 is what controls, and each part's official title is the only description of it this page will assert.
| Scoped CFR part | Title in the eCFR | Function that would own the read | Evidence a reviewer would want |
|---|---|---|---|
| 42 CFR Part 400 | Introduction; Definitions | Compliance owner | Which definitions the practice relies on |
| 42 CFR Part 405 | Federal Health Insurance for the Aged and Disabled | Compliance owner | Current internal policy and its author |
| 42 CFR Part 406 | Hospital Insurance Eligibility and Entitlement | Patient access | Eligibility-check procedure in use |
| 42 CFR Part 407 | Supplementary Medical Insurance (SMI) Enrollment and Entitlement | Patient access | Enrollment scripts and their owner |
| 42 CFR Part 410 | Supplementary Medical Insurance (SMI) Benefits | Coding and coverage | Coverage determinations the practice applies |
| 42 CFR Part 414 | Payment for Part B Medical and Other Health Services | Billing and coding | Fee-schedule mapping and who maintains it |
| 42 CFR Part 415 | Services Furnished by Physicians in Providers, Supervising Physicians in Teaching Settings, and Residents in Certain Settings | Physician supervision owner | Supervision attestations on file |
| 42 CFR Part 417 | Health Maintenance Organizations, Competitive Medical Plans, and Health Care Prepayment Plans | Managed-care contracting | Contract inventory and renewal owner |
| 42 CFR Part 422 | Medicare Advantage Program | Managed-care contracting | Plan participation records |
| 42 CFR Part 423 | Voluntary Medicare Prescription Drug Benefit | Pharmacy and drug billing | Drug billing configuration history |
| 42 CFR Part 424 | Conditions for Medicare Payment | Revenue cycle and enrollment | Enrollment records and revalidation dates |
| 42 CFR Part 425 | Medicare Shared Savings Program | Value-based care lead | Participation agreement and its owner |
| 42 CFR Part 427 | Medicare Part B Drug Inflation Rebate Program | Pharmacy and drug billing | Rebate-related reporting the practice produces |
| 42 CFR Part 428 | Medicare Part D Drug Inflation Rebate Program | Pharmacy and drug billing | Rebate-related reporting the practice produces |
| 42 CFR Part 512 | Standard Provisions for Mandatory Innovation Center Models and Specific Provisions for Certain Models | Model participation lead | Model agreements and status |
The owner column is an operational suggestion for routing a read, not a claim about what any part contains beyond its title. A practice's compliance owner should confirm the assignment, and the primary text at eCFR title 42 should settle any disagreement between this page and the regulation.
The electronic Code of Federal Regulations text for title 42 was current to 2026-07-24 when this brief was prepared, and title 42 was last amended on 2026-07-20. Those two stamps are the honest bound on how fresh any summary of the current regulation can be, including this one. eCFR
A practical way to use the table is to run down the left column once, assign a named person to each row, and let the ones with no plausible owner fall away. What remains is the practice's actual exposure to this proposal, and it is usually much shorter than the full list.
| Field to log in the compliance record | Value |
|---|---|
| Federal Register citation | 91 FR 43842 |
| Regulation identifier number | 0938-AV82 |
| Published in the Federal Register | July 16, 2026 |
| Comment deadline — the date the record closes | September 14, 2026 |
| eCFR title 42 current as of | 2026-07-24 |
| eCFR title 42 last amended on | 2026-07-20 |
Those are the strings worth pasting into a compliance calendar entry verbatim. A record that carries the citation and the regulation identifier number can be reconciled against the Federal Register later; a record that says only "Medicare proposal" cannot.
Operationalizing the workflow at volume
US Tech Automations can connect a deadline tracker, a routing queue, and an approval record so that one calendar entry for the closing date fans out into a task per scoped part, each routed to a named owner, with the drafted comment and its approver captured against the entry. The tracker holds the date; people hold the judgment.
Three things are worth automating and nothing more. First, the closing date itself, monitored so a reopening or an extension is noticed rather than assumed. Second, intake: each scoped part queued to billing, reporting, clinic operations, or drug billing, with an escalation if a queue item has no owner. Third, an audit trail recording which items the practice commented on, who drafted each comment, and who approved the submission.
The US Tech Automations agentic-workflow platform is built for that shape of work: connected intake, routed queues, recorded approvals, and monitoring that escalates a stalled item to a person. It should sit around the practice's governance model rather than inside it, and it should never be the place a legal interpretation is made.
Start small enough to measure. One proposal, one queue, one approver, and a count of how many times somebody had to chase a document. That baseline tells a practice whether orchestration is reducing administrative friction or simply relocating it.
Frequently asked questions
Is the CY 2027 physician fee schedule rule final?
No. The document at 91 FR 43842 is a proposed rule. Nothing in it is in force, there is no effective date attached to it, and it may be withdrawn, reproposed, or issued in a different form. Federal Register
When does the comment period close?
To be assured consideration, comments must be received by September 14, 2026. That date is the point at which the rulemaking record closes, and it is not a date by which a practice would have to change anything. Federal Register
Which Medicare programs does the proposal say it would touch?
Its abstract names the physician fee schedule, other Part B payment policies, the Medicare Prescription Drug Inflation Rebate Program, the Ambulatory Specialty Model, Part B drugs and biological products, Medicare Shared Savings Program requirements, the Quality Payment Program, Rural Health Clinics and Federally Qualified Health Centers, the Ambulance Fee Schedule, Clinical Laboratory Fee Schedule regulations, and the Medicare Promoting Interoperability Program. Federal Register
Does this proposal change what a practice bills today?
No. A proposal describes what an agency is considering. Billing today continues to be governed by the regulation currently in force, whose text sits at eCFR title 42, and by the practice's own coverage and coding determinations.
Who inside a practice should own the response to a proposed rule?
That depends on the practice, and the answer should be written down rather than assumed. A workable pattern is a single accountable owner for the comment window, with each scoped subject routed to the function that operates it — billing, reporting, clinic operations, drug billing — and one approver for anything the practice submits.
How can a practice track a comment deadline without automating clinical or legal judgment?
Track observable states only: whether the document is still open, whether each routed item has an owner, whether a draft exists, and whether an approver has signed off. Route anything ambiguous to a person with evidence attached. The workflow manages the case; a qualified professional decides what the proposal means for the practice.
Related guidance
Source: Federal Register / eCFR (91 FR 43842).
Last reviewed: July 28, 2026
Every date, citation, RIN, CFR reference, and figure in this post is copied verbatim from the Federal Register and eCFR as of the snapshot date. Nothing is estimated, modeled, or extrapolated. This is not legal or tax advice.
Disclaimer
This page is for informational purposes only. It is not legal or tax advice, creates no attorney-client relationship, and does not determine whether any practice is affected by this proposal or how it should respond. Consult a qualified professional about the proposed rule, the parts of title 42 it names, and the organization's own facts. eCFR
US Tech Automations provides workflow orchestration rather than compliance determinations. See platform pricing when the practice is ready to scope deadline tracking, routed intake, and an approval trail around accountable human owners.
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