"Healthcare groups are reacting to CMS' proposed 2026 Physician Fee Schedule mainly with concern, arguing that it needs significant revisions in order to avoid destabilizing providers and undermining value-based care momentum. The proposal, issued in July, seeks to establish two new conversion factors - one for physicians in advanced alternative payment models (APMs) and another for those who aren't. CMS plans to increase the APM rate by 3.83% in 2026, while the non-APM rate would go up by 3.62%."
"These increases reflect several factors - a small statutory bump (0.75% for APM participants and 0.25% for others), an across-the-board 2.5% increase required by recent legislation, and an additional 0.55% adjustment tied to CMS' proposed changes in physician work relative value units (wRVUs). For 2026, CMS is also proposing to trim payments by applying a 2.5% "efficiency adjustment" to certain wRVUs."
CMS proposes separate conversion factors for physicians in advanced alternative payment models (APMs) and those who are not, increasing the APM factor by 3.83% and the non-APM factor by 3.62% for 2026. The changes reflect a statutory bump (0.75% for APM participants, 0.25% for others), a 2.5% across-the-board legislative increase, and a 0.55% adjustment tied to proposed physician work relative value unit (wRVU) changes. CMS also proposes a 2.5% "efficiency adjustment" to certain wRVUs, lowering credited physician work and reducing reimbursement for affected codes. Proposed reductions to indirect practice expense payments would lower facility-based service reimbursements while modestly increasing office-based payments. The Medical Group Management Association (MGMA) and other healthcare groups objected, saying the proposed rates do not offset prior cuts and could destabilize providers and undermine value-based care progress. CMS set a comment deadline of September 12.
Read at MedCity News
Unable to calculate read time
Collection
[
|
...
]