CMS Finalizes 2026 Medicare Physician Fee Schedule with Incremental Conversion Factor Increases and New Payment Models

CMS has finalized the 2026 Medicare Physician Fee Schedule, introducing two separate conversion factors: one for providers participating in qualifying advanced alternative payment models (APMs) and another for non-qualifying practitioners. The conversion factor for qualified providers will increase by 3.77% to $33.57, while non-qualifying providers will see a 3.26% increase to $33.40. The rule includes a one-year 2.5% increase mandated by legislation and a 0.49% adjustment for updated work relative value units (RVUs), alongside a controversial 2.5% efficiency adjustment cut applied to many non-time-based services to reflect gains in care delivery efficiency. While the American Medical Association acknowledges the positive aspects, such as telehealth provisions and a critical one-time update, it also expressed concern that the efficiency adjustment and payment changes could threaten the viability of independent practices. Specific reimbursement rates for certain procedures, such as the UltraMIST wound care treatment (CPT code 97610), remain largely unchanged for 2026, aligning with prior expectations.