feat(pfs): CY2027 final rule parameters; fix CY2025/2026 telehealth fees

RULES[2027] from the CY2027 PFS final rule (CMS-1848-F, 91 FR 70992,
:pincite:JCWARTJD): non-QP CF 32.6286, QP CF 32.9548, non-QP anesthesia
20.1056 (QP 20.3068 noted), -0.12% budget neutrality (91 FR 71653), and
the Q3014 fee $32.68 read from Table A-C1, an image at 91 FR 71027.
The NPRM block moves from PROPOSED[2027] to RULES[2027].proposed, so
proposed_for(2027) is unchanged for callers; PROPOSED is empty until
CY2028's NPRM.

Table A-C1 is CMS's full Q3014 history, and it shows two registry
errors: CY2025 held 29.96 (CY2024's fee; correct $31.01) and CY2026
held 30.38 (no such year; correct $31.85).

src/pfs/rules/__init__.py

@@ -25,7 +25,9 @@ Mid-year CF splits documented by :pincite:`VVBEVYLC`::
 
 All other CY2002 – CY2026 years have a single CF for the full year.
 CY2026 is the first year with four simultaneous CFs (APM / non-APM
-× standard / anesthesia) under MACRA 2015.
+× standard / anesthesia) under MACRA 2015. CY2027 (CMS-1848-F) keeps the
+split; its CFs come from the final rule itself (:pincite:`JCWARTJD`),
+not the AMA table, which had not published CY2027 at transcription.
 
 Usage::
 
@@ -49,17 +51,17 @@ one applies:
   (P36 shape; see e.g. ``RULES[2026].proposed``).
 * ``PROPOSED[year]`` — a module-level registry for years whose NPRM
   has been transcribed but which have **no** Final Rule yet, so there
-  is no ``RULES[year]`` to hang it on (e.g. CY2027 as of this
-  writing — see ``PROPOSED[2027]`` below).
+  is no ``RULES[year]`` to hang it on (CY2027 lived here from its
+  July 2026 NPRM until the final rule of Nov 9, 2026; empty since).
 
 Use ``proposed_for(year)`` rather than reaching into either dict
 directly — it returns ``RULES[year].proposed`` when ``year`` is in
 ``RULES``, else ``PROPOSED.get(year)``, else ``None``.  This is a
-migration path: when CY2027's Final Rule eventually ships,
-``RULES[2027]`` gets created with its own ``proposed=...`` block and
-the ``PROPOSED[2027]`` entry is retired — ``proposed_for(2027)``
-keeps returning the right thing across that move without callers
-changing.  ``RuleYear`` itself needs no change for this to work.
+migration path: when a year's Final Rule ships, ``RULES[year]`` gets
+created with its own ``proposed=...`` block and the ``PROPOSED[year]``
+entry is retired — ``proposed_for(year)`` keeps returning the right
+thing across that move without callers changing (CY2027 made the move
+on 2026-11-11).  ``RuleYear`` itself needs no change for this to work.
 """
 
 from __future__ import annotations
@@ -420,7 +422,10 @@ RULES: dict[int, RuleYear] = {
             2025, 32.3465, "expiration of CY2024 temporary 2.93% update"
         ),
         clinical_labor_rate_update=True,
-        telehealth_originating_site_fee=29.96,
+        # Was 29.96 — that is CY2024's fee. CMS's Q3014 history,
+        # Table A-C1 of the CY2027 final rule (91 FR 71027), gives
+        # CY2025 = $31.01 (MEI 3.5%).
+        telehealth_originating_site_fee=31.01,
         federal_register_citation="89 FR 98452",
     ),
     2026: RuleYear(
@@ -442,7 +447,10 @@ RULES: dict[int, RuleYear] = {
         anesthesia_cf=20.4976,  # non-APM anesthesia
         budget_neutrality_adjustor=1.0049,  # +0.49% BN adjustment
         clinical_labor_rate_update=True,
-        telehealth_originating_site_fee=30.38,
+        # Was 30.38, which matches no year in CMS's Q3014 history
+        # (Table A-C1, 91 FR 71027): CY2026 = $31.85 (MEI 2.7%),
+        # the same amount the NPRM proposed.
+        telehealth_originating_site_fee=31.85,
         # Corrected from "90 FR 101174" (mistranscribed; no such page in
         # this rule). The Final Rule (RIN 0938-AV50, Vol. 90 No. 212,
         # Nov 5, 2025) runs 90 FR 49266-50481; per this registry's
@@ -474,6 +482,93 @@ RULES: dict[int, RuleYear] = {
             ),
         ),
     ),
+    2027: RuleYear(
+        # CY2027 PFS Final Rule (CMS-1848-F), FR Doc 2026-22743,
+        # 91 FR 70992-72020, published 2026-11-09, effective
+        # 2027-01-01, per :pincite:`JCWARTJD`. CFs and the BN adjustor
+        # are the RIA's CF derivation at 91 FR 71653
+        # (data/fr_downloads/2026-22743.txt lines ~67750-67767): the
+        # CY2026 CFs *without* the one-year 2.50% statutory increase,
+        # times a -0.12% budget-neutrality adjustment, times the
+        # section 1848(d)(20) updates (QP +0.75%, non-QP +0.25%).
+        year=2027,
+        conversion_factor=32.6286,  # nonqualifying APM standard
+        cf_qp=32.9548,  # qualifying APM standard
+        cf_segments=_full_year(
+            2027,
+            32.6286,
+            "non-APM standard CF; CY2026's one-year 2.50% increase removed",
+        ),
+        # Nonqualifying APM anesthesia CF; the QP anesthesia CF is
+        # 20.3068 (same sentence, 91 FR 71653) — RuleYear has no field
+        # for it yet.
+        anesthesia_cf=20.1056,
+        budget_neutrality_adjustor=0.9988,  # "-0.12 percent"
+        # HCPCS Q3014, Table A-C1 (an image in both the PDF and the
+        # text edition), 91 FR 71027: $32.68, MEI 2.6%.
+        telehealth_originating_site_fee=32.68,
+        # clinical_labor_rate_update / supply_equipment_price_update
+        # stay False: the rule continues only a phased pricing
+        # transition for three supply packs (Table A-B4), no general
+        # clinical-labor or supply/equipment refresh.
+        federal_register_citation="91 FR 70992",
+        # NPRM values, moved here from PROPOSED[2027] when the Final
+        # Rule shipped (see module docstring).
+        proposed=ProposedRule(
+            # CY2027 PFS NPRM (CMS-1848-P), 91 FR 43842, published
+            # 2026-07-16, comment period closes 2026-09-14 per the DATES
+            # block. Transcribed from data/fr_downloads/2026-14327.txt
+            # per :pincite:`5ITGVDJV`.
+            cms_rule_id="CMS-1848-P",
+            fr_document_number="2026-14327",
+            federal_register_citation="91 FR 43842",
+            published=date(2026, 7, 16),
+            comment_close=date(2026, 9, 14),
+            # Nonqualifying-APM (non-QP) standard CF — RIA detailed
+            # derivation, file line ~39099 (91 FR 44242): "We estimate the
+            # CY 2027 PFS nonqualifying APM CF to be 32.8409".
+            conversion_factor=32.8409,
+            # Qualifying-APM (QP) standard CF — file line ~39095
+            # (91 FR 44242): "We estimate the CY 2027 PFS qualifying APM
+            # CF to be 33.1693".
+            cf_qp=33.1693,
+            # Nonqualifying-APM anesthesia CF — file line ~39104
+            # (91 FR 44242): "the CY 2027 anesthesia nonqualifying APM CF
+            # to be 20.2143".
+            anesthesia_cf=20.2143,
+            # Qualifying-APM anesthesia CF — file line ~39103
+            # (91 FR 44242): "We estimate the CY 2027 anesthesia
+            # qualifying APM CF to be 20.4165".
+            anesthesia_cf_qp=20.4165,
+            # "0.53 percent positive budget neutrality adjustment", stated
+            # identically for both QP and non-QP CFs at file lines
+            # ~39096 and ~39100 (91 FR 44242).
+            budget_neutrality_adjustor=1.0053,
+            # HCPCS Q3014 — file line ~2261 (91 FR 43843): "the proposed
+            # payment amount for HCPCS code Q3014 (Telehealth originating
+            # site facility fee) is $32.65".
+            telehealth_originating_site_fee=32.65,
+            notes=(
+                "Transcribed from data/fr_downloads/2026-14327.txt (NPRM "
+                "full text) per :pincite:`5ITGVDJV`. Standard and "
+                "anesthesia QP/non-QP CFs plus the BN adjustor are from "
+                "the Regulatory Impact Analysis's detailed CF derivation "
+                "(section VII.D, file lines ~39088-39106, 91 FR "
+                "44242) — the earlier plain-language Summary of Costs and "
+                "Benefits (file lines ~359-364, 91 FR 43842) states the "
+                "same $0.40/$0.56 deltas but pairs them with the WRONG "
+                "'current' (CY2026) CF labels/values (mixes CY2026 final "
+                "non-QP $33.4009 with CY2026 *proposed* QP $33.5875, "
+                "rather than CY2026 final QP $33.5675) — an apparent "
+                "drafting error in the published NPRM text itself, not a "
+                "transcription artifact here. Update-factor components "
+                "(also file lines ~39085-39087): QP update +0.75%, "
+                "non-QP update +0.25% (section 1848(d)(20)), not modelled "
+                "as separate fields. Comment-close DATES block at file "
+                "lines 108-109 (91 FR 43842)."
+            ),
+        ),
+    ),
 }
 
 
@@ -481,70 +576,15 @@ RULES: dict[int, RuleYear] = {
 #
 # `RuleYear.proposed` (above) is the home for NPRM parameters once a
 # year has a Final Rule to hang them on (P36 shape, e.g. RULES[2026]).
-# CY2027's NPRM (CMS-1848-P) has no Final Rule yet, so RULES has no
-# 2027 entry — `PROPOSED` holds `ProposedRule` values for such
-# final-less years. When CY2027's Final Rule ships, `RULES[2027]` is
-# created with `proposed=PROPOSED[2027]` (or an equivalent
-# re-transcription) and the `PROPOSED[2027]` entry is retired —
-# callers that used `proposed_for(2027)` see no change since the
-# helper checks `RULES` first.
+# `PROPOSED` holds `ProposedRule` values for years whose NPRM is out
+# but whose Final Rule is not. When the Final Rule ships, `RULES[year]`
+# is created with `proposed=` that block and the `PROPOSED[year]` entry
+# is retired — callers that used `proposed_for(year)` see no change
+# since the helper checks `RULES` first. Empty since CY2027's final
+# rule (CMS-1848-F) moved its NPRM under RULES[2027]; CY2028's NPRM
+# (expected July 2027) goes here first.
 
-PROPOSED: dict[int, ProposedRule] = {
-    2027: ProposedRule(
-        # CY2027 PFS NPRM (CMS-1848-P), 91 FR 43842, published
-        # 2026-07-16, comment period closes 2026-09-14 per the DATES
-        # block. Transcribed from data/fr_downloads/2026-14327.txt
-        # per :pincite:`5ITGVDJV`.
-        cms_rule_id="CMS-1848-P",
-        fr_document_number="2026-14327",
-        federal_register_citation="91 FR 43842",
-        published=date(2026, 7, 16),
-        comment_close=date(2026, 9, 14),
-        # Nonqualifying-APM (non-QP) standard CF — RIA detailed
-        # derivation, file line ~39099 (91 FR 44242): "We estimate the
-        # CY 2027 PFS nonqualifying APM CF to be 32.8409".
-        conversion_factor=32.8409,
-        # Qualifying-APM (QP) standard CF — file line ~39095
-        # (91 FR 44242): "We estimate the CY 2027 PFS qualifying APM
-        # CF to be 33.1693".
-        cf_qp=33.1693,
-        # Nonqualifying-APM anesthesia CF — file line ~39104
-        # (91 FR 44242): "the CY 2027 anesthesia nonqualifying APM CF
-        # to be 20.2143".
-        anesthesia_cf=20.2143,
-        # Qualifying-APM anesthesia CF — file line ~39103
-        # (91 FR 44242): "We estimate the CY 2027 anesthesia
-        # qualifying APM CF to be 20.4165".
-        anesthesia_cf_qp=20.4165,
-        # "0.53 percent positive budget neutrality adjustment", stated
-        # identically for both QP and non-QP CFs at file lines
-        # ~39096 and ~39100 (91 FR 44242).
-        budget_neutrality_adjustor=1.0053,
-        # HCPCS Q3014 — file line ~2261 (91 FR 43843): "the proposed
-        # payment amount for HCPCS code Q3014 (Telehealth originating
-        # site facility fee) is $32.65".
-        telehealth_originating_site_fee=32.65,
-        notes=(
-            "Transcribed from data/fr_downloads/2026-14327.txt (NPRM "
-            "full text) per :pincite:`5ITGVDJV`. Standard and "
-            "anesthesia QP/non-QP CFs plus the BN adjustor are from "
-            "the Regulatory Impact Analysis's detailed CF derivation "
-            "(section VII.D, file lines ~39088-39106, 91 FR "
-            "44242) — the earlier plain-language Summary of Costs and "
-            "Benefits (file lines ~359-364, 91 FR 43842) states the "
-            "same $0.40/$0.56 deltas but pairs them with the WRONG "
-            "'current' (CY2026) CF labels/values (mixes CY2026 final "
-            "non-QP $33.4009 with CY2026 *proposed* QP $33.5875, "
-            "rather than CY2026 final QP $33.5675) — an apparent "
-            "drafting error in the published NPRM text itself, not a "
-            "transcription artifact here. Update-factor components "
-            "(also file lines ~39085-39087): QP update +0.75%, "
-            "non-QP update +0.25% (section 1848(d)(20)), not modelled "
-            "as separate fields. Comment-close DATES block at file "
-            "lines 108-109 (91 FR 43842)."
-        ),
-    ),
-}
+PROPOSED: dict[int, ProposedRule] = {}
 
 
 def proposed_for(year: int) -> ProposedRule | None:
@@ -552,8 +592,8 @@ def proposed_for(year: int) -> ProposedRule | None:
 
     Looks up ``RULES[year].proposed`` when ``year`` has a Final Rule
     entry in ``RULES``; otherwise falls back to ``PROPOSED.get(year)``
-    for years whose NPRM has no Final Rule yet (e.g. CY2027 as of this
-    writing — see ``PROPOSED`` above). Returns ``None`` if neither
+    for years whose NPRM has no Final Rule yet (see ``PROPOSED``
+    above). Returns ``None`` if neither
     source has proposed parameters for ``year``.
 
     This indirection is what lets a year migrate from ``PROPOSED`` to

tests/pfs/test_rules.py

@@ -104,21 +104,21 @@ class TestRuleYear:
 
 
 class TestRulesDict:
-    """RULES maps calendar year -> RuleYear for 2014-2026."""
+    """RULES maps calendar year -> RuleYear for 2014-2027."""
 
-    EXPECTED_YEARS = list(range(2014, 2027))
+    EXPECTED_YEARS = list(range(2014, 2028))
 
     def test_count(self):
-        assert len(RULES) == 13
+        assert len(RULES) == 14
 
     def test_keys(self):
         assert sorted(RULES.keys()) == self.EXPECTED_YEARS
 
-    @pytest.mark.parametrize("year", list(range(2014, 2027)))
+    @pytest.mark.parametrize("year", list(range(2014, 2028)))
     def test_values_are_ruleyear(self, year):
         assert isinstance(RULES[year], RuleYear)
 
-    @pytest.mark.parametrize("year", list(range(2014, 2027)))
+    @pytest.mark.parametrize("year", list(range(2014, 2028)))
     def test_year_field_matches_key(self, year):
         assert RULES[year].year == year
 
@@ -156,7 +156,8 @@ class TestSpecificValues:
         assert cy2026.cf_qp == 33.5675
 
     def test_cy2026_telehealth_fee(self):
-        assert cy2026.telehealth_originating_site_fee == 30.38
+        # Table A-C1 (Q3014 history), 91 FR 71027 — was mis-recorded as 30.38.
+        assert cy2026.telehealth_originating_site_fee == 31.85
 
     def test_cy2026_federal_register(self):
         assert cy2026.federal_register_citation == "90 FR 49266"
@@ -168,7 +169,8 @@ class TestSpecificValues:
         assert cy2025.conversion_factor == 32.3465
 
     def test_cy2025_telehealth_fee(self):
-        assert cy2025.telehealth_originating_site_fee == 29.96
+        # Table A-C1, 91 FR 71027 — 29.96 was CY2024's fee.
+        assert cy2025.telehealth_originating_site_fee == 31.01
 
     def test_cy2024_conversion_factor(self):
         assert cy2024.conversion_factor == 33.2875
@@ -319,11 +321,14 @@ class TestProposedForHelper:
         # should return that same object, not consult PROPOSED.
         assert proposed_for(2026) is RULES[2026].proposed
 
-    def test_resolves_from_proposed_registry_when_year_absent_from_rules(self):
-        # 2027 has no Final Rule yet — no RULES[2027] — so proposed_for
-        # falls back to the PROPOSED registry.
-        assert 2027 not in RULES
-        assert proposed_for(2027) is PROPOSED[2027]
+    def test_resolves_from_proposed_registry_when_year_absent_from_rules(
+        self, monkeypatch
+    ):
+        # A final-less year (CY2028's NPRM, next July) lives in PROPOSED.
+        prop = RULES[2027].proposed.model_copy(update={"cms_rule_id": "CMS-9999-P"})
+        monkeypatch.setitem(PROPOSED, 2028, prop)
+        assert 2028 not in RULES
+        assert proposed_for(2028) is prop
 
     def test_missing_year_returns_none(self):
         assert proposed_for(1999) is None
@@ -335,15 +340,16 @@ class TestProposedForHelper:
         assert RULES[2025].proposed is None
         assert proposed_for(2025) is None
 
-    def test_2027_in_proposed_not_rules(self):
-        assert 2027 in PROPOSED
-        assert 2027 not in RULES
-        with pytest.raises(KeyError):
-            RULES[2027]  # noqa: B018
+    def test_2027_moved_from_proposed_to_rules(self):
+        # The CY2027 final rule shipped: its NPRM block now hangs off
+        # RULES[2027] and the PROPOSED entry is retired.
+        assert 2027 not in PROPOSED
+        assert proposed_for(2027) is RULES[2027].proposed
+        assert proposed_for(2027).cms_rule_id == "CMS-1848-P"
 
 
 class TestCy2027Proposed:
-    """PROPOSED[2027] — CY2027 NPRM (CMS-1848-P) transcribed values.
+    """proposed_for(2027) — CY2027 NPRM (CMS-1848-P) transcribed values.
 
     Source: data/fr_downloads/2026-14327.txt, 91 FR 43842, published
     2026-07-16.  Per :pincite:`5ITGVDJV`.
@@ -352,7 +358,7 @@ class TestCy2027Proposed:
     def test_identity_fields(self):
         from datetime import date
 
-        p = PROPOSED[2027]
+        p = proposed_for(2027)
         assert p.cms_rule_id == "CMS-1848-P"
         assert p.fr_document_number == "2026-14327"
         assert p.federal_register_citation == "91 FR 43842"
@@ -363,31 +369,62 @@ class TestCy2027Proposed:
 
         # DATES block, file lines 108-109: "comments must be received
         # ... by September 14, 2026."
-        assert PROPOSED[2027].comment_close == date(2026, 9, 14)
-        assert PROPOSED[2027].comment_close > PROPOSED[2027].published
+        assert proposed_for(2027).comment_close == date(2026, 9, 14)
+        assert proposed_for(2027).comment_close > proposed_for(2027).published
 
     def test_standard_conversion_factors(self):
-        p = PROPOSED[2027]
+        p = proposed_for(2027)
         # RIA detailed derivation, file lines ~39095-39102 (91 FR 44242).
         assert p.cf_qp == 33.1693  # qualifying APM
         assert p.conversion_factor == 32.8409  # nonqualifying APM
 
     def test_anesthesia_conversion_factors(self):
-        p = PROPOSED[2027]
+        p = proposed_for(2027)
         assert p.anesthesia_cf_qp == 20.4165  # qualifying APM
         assert p.anesthesia_cf == 20.2143  # nonqualifying APM
 
     def test_budget_neutrality_adjustor(self):
         # "0.53 percent positive budget neutrality adjustment"
-        assert PROPOSED[2027].budget_neutrality_adjustor == 1.0053
+        assert proposed_for(2027).budget_neutrality_adjustor == 1.0053
 
     def test_telehealth_originating_site_fee(self):
         # HCPCS Q3014, file line ~2261 (91 FR 43843): "$32.65"
-        assert PROPOSED[2027].telehealth_originating_site_fee == 32.65
+        assert proposed_for(2027).telehealth_originating_site_fee == 32.65
 
     def test_not_equal_to_cy2026_final_or_proposed(self):
-        p2027 = PROPOSED[2027]
+        p2027 = proposed_for(2027)
         p2026 = RULES[2026].proposed
         assert p2027.conversion_factor != RULES[2026].conversion_factor
         assert p2027.conversion_factor != p2026.conversion_factor
         assert p2027.cf_qp != p2026.cf_qp
+
+
+class TestCy2027Final:
+    """RULES[2027] — CY2027 PFS Final Rule (CMS-1848-F), 91 FR 70992,
+    published 2026-11-09, per :pincite:`JCWARTJD`. CF sentence at
+    91 FR 71653; Q3014 fee in Table A-C1, 91 FR 71027."""
+
+    def test_conversion_factors(self):
+        r = RULES[2027]
+        assert r.conversion_factor == 32.6286  # nonqualifying APM
+        assert r.cf_qp == 32.9548  # qualifying APM
+        assert r.anesthesia_cf == 20.1056  # nonqualifying APM anesthesia
+
+    def test_budget_neutrality_and_fee(self):
+        r = RULES[2027]
+        assert r.budget_neutrality_adjustor == 0.9988  # -0.12 percent
+        assert r.telehealth_originating_site_fee == 32.68
+
+    def test_citation_and_single_segment(self):
+        from datetime import date
+
+        r = RULES[2027]
+        assert r.federal_register_citation == "91 FR 70992"
+        assert r.cf_for_date(date(2027, 7, 1)) == 32.6286
+
+    def test_final_differs_from_proposed(self):
+        r = RULES[2027]
+        # NPRM 32.8409 / 33.1693 → final 32.6286 / 32.9548: BN flipped
+        # from +0.53% proposed to -0.12% final.
+        assert r.conversion_factor < r.proposed.conversion_factor
+        assert r.cf_qp < r.proposed.cf_qp