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# CMS proposes raising the ACO benchmark ratchet-relief factor from 50% to 75%
- URL: https://members.americanhealthintel.com/2026-07-20-serviceline/
- Published: 2026-07-21T00:18:47.000Z
- Updated: 2026-07-21T00:18:47.000Z
- Description: Plus: G2211 becomes a modifier, new ACO-only modifier added, RPM/RTM staffing tightened. The day's rules, money, and enforcement, sourced and tiered below.
- Author: American Health Intel

Plus: G2211 becomes a modifier, new ACO-only modifier added, RPM/RTM staffing tightened. The day's rules, money, and enforcement, sourced and tiered below.

| American Health Intel Rules · Money · Medicine · Decoded daily The Service Line Monday, July 20, 2026 CMS proposes raising the ACO benchmark ratchet-relief factor from 50% to 75% Plus: G2211 becomes a modifier, new ACO-only modifier added, RPM/RTM staffing tightened. The day's rules, money, and enforcement, sourced and tiered below. ![](https://americanhealthintel.com/email/pulse-divider.png) Rule Confidence: High CMS just proposed rewriting how every Medicare accountable care organization's savings targets get set, raising the factor that decides how much of an ACO's own success shrinks its next benchmark from 50% to 75%. Part of the CY2027 Physician Fee Schedule rule released July 14\. CMS also proposes raising the top ACO shared-savings rate to 60% and capping how far its regional cost projections can miss. Comments close September 14, 2026. Why it matters This rewrites how much of an ACO's own savings get folded back into next year's target, the biggest change to ACO benchmarking math in years. Watch whether the ratchet-relief and guardrail provisions survive comment unchanged by September 14. Sources: [CMS](https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-physician-fee-schedule-proposed-rule-cms-1848-p-medicare-shared?ref=members.americanhealthintel.com) · [Federal Register](https://www.federalregister.gov/documents/2026/07/16/2026-14327/medicare-and-medicaid-programs-cy-2027-payment-policies-under-the-physician-fee-schedule-and-other?ref=members.americanhealthintel.com) · [NAACOS](https://www.naacos.com/wp-content/uploads/2026/03/2026-Modernize-ACOs-Recommendations.pdf?ref=members.americanhealthintel.com) Rule Confidence: High Medicare's same rule turns a flat primary care payment add-on into a 16% pay bump on the office visit itself, plus a new 32% bump only for doctors inside an accountable care organization. The catch, remote patient monitoring codes can now only be billed by staff the practice directly employs, not outside vendors, and remote therapeutic monitoring is limited to established patients. Chronic care management is untouched. Why it matters Two Medicare payment changes here: a bigger bonus for complex office visits, and a tighter staffing rule for remote monitoring billing that could squeeze practices relying on contracted monitoring staff. Watch whether the RPM staffing requirement holds through the final rule. Sources: [CMS](https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2027-medicare-physician-fee-schedule-proposed-rule?ref=members.americanhealthintel.com) Also today OIG audits chronic care management patient eligibility, not just documentation [Read](https://americanhealthintel.com/editions/2026-07-20-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#oig-ccm-eligibility-audit-2026) Pediatrica raises $28M Series B, Astrana Health ACOs post $120.4M shared savings [Read](https://americanhealthintel.com/editions/2026-07-20-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#pediatrica-astrana-primary-care-capital) New York extends nurse practitioner independent practice authority to 2030 [Read](https://americanhealthintel.com/editions/2026-07-20-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#ny-np-independent-practice-2030) 186Records$16.0BEnforcement7Deadlines68Rules [Read this issue + the trackers](https://americanhealthintel.com/editions/2026-07-20-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) Pick your field on the site and every story tells you what it means for you. Reply to this email and tell us what you want covered. We read everything. We show our work. We score our own calls. [Track record](https://americanhealthintel.com/ledger/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [Calendar](https://americanhealthintel.com/calendar/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [Enforcement](https://americanhealthintel.com/enforcement/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [X](https://x.com/amhealthintel?ref=members.americanhealthintel.com) · [LinkedIn](https://www.linkedin.com/company/american-health-intel?ref=members.americanhealthintel.com) News and analysis, not legal, medical, coding, or investment advice.You subscribed at americanhealthintel.com · [Unsubscribe](%%{unsubscribe%5Furl}%%) |
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