Contract intelligence
Structure payer products, fee schedules, Medicare tiebacks, and effective dates in one usable model.
Practice financial intelligence
Fulcrum for Dermatology.
See how every contract, payment, and service line performs. Connect office visits, biopsies, excisions, destruction procedures, and Mohs volume to the payer terms that determine revenue.
Financial visibility for Dermatology
Procedure-heavy encounters make contract performance difficult to see.
A single dermatology encounter can combine an office visit with biopsies, destruction, excision, or Mohs services. Fulcrum connects that code mix to each payer's reimbursement logic so finance teams can see what should have been paid and what each service contributes.
One connected intelligence layer
Built for the questions your finance team actually has.
Payment monitoring
Detect and investigate potential underpayments in an automated, accurate way.
Forecasts & negotiations
Test proposed rates against actual volume and bring clear evidence into payer conversations.
Service-line economics
Integrate encounter and cost data to see precise unit economics for specific CPT codes.
What becomes answerable
Move from reported revenue to financial context.
- 01Which payer products are underperforming?
- 02Which payments do not match the contract?
- 03How will a proposed rate change affect revenue?
- 04Which services produce the strongest unit economics?
CY 2027 proposed PFS
What the proposed rule could mean for Dermatology.
A national specialty average is useful context, not a practice forecast. Your result depends on your codes, volume, locality, sites of service, and Medicare-linked contracts.
-9.4%CMS specialty estimate
-9.9%Fulcrum reconstruction
CMS's projected overall impact for Dermatology
CMS's own reconciliation table (Table D-B5) puts dermatology at -9.4% for 2027. That figure is the specialty-wide, volume-weighted change in total RVU-based allowed charges: the aggregate gain or loss across every code the specialty bills, before the separate conversion-factor cut. Fulcrum's reconstruction agrees closely at -9.9%, a net reduction of $356 million in national allowed charges.
Dermatology bills about 97% of its Medicare dollars in the office (non-facility) setting. By site of service, the 2027 change splits as follows:
| Site of service | Change | Allowed $ |
|---|---|---|
| Office (non-facility) | -10.1% | -$348M |
| Facility | -7.0% | -$8M |
All figures are national, hold 2025 utilization fixed, and exclude the separate 1.68% conversion-factor cut that lands on every specialty on top of this.
The average hides the practice-level spread.
The specialty average hides a wide spread, demonstrated well by CMS's impact files. 54% of dermatology practitioners land in the -20 to -10% band, with 92% overall seeing a cut deeper than 2%. Where a practice lands is a question of service mix: the practices hit hardest are those with the heaviest same-day billing (an office visit alongside a destruction, biopsy, excision, or Mohs procedure).
Practice-specific analysis
See what your contracts and service mix say.
Start with one contract, one fee-schedule question, or an ongoing view across the practice.