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CMS Releases CY 2026 Medicare Part B Physician Fee Schedule Final Rule

The Centers for Medicare and Medicaid Services (CMS) issued a final rule establishing final payment rate?under the Medicare Part B Physician Fee Schedule (PFS) and other policy updates for Calendar Year (CY) 2026. The rule will become effective for items and services beginning on January 1, 2026.

AHCA/NCAL has reviewed the final rule and developed a detailed summary outlining key provisions and impacts on members. Please note this is for members only and requires an AHCA/NCAL log-in to view.

Key points from the final rule include:
  • A 3.26 percent increase in the base conversion factor for Medicare Part B services such as outpatient therapy services furnished by SNF providers.
  • Revised telehealth provisions that help to assure more timely and consistent AHCA/NCAL member resident access to medical services in their residence 24/7/365.
  • Removal of all time-based outpatient therapy codes from the proposed efficiency adjustment list.
CMS has also shared a fact sheet about the final rule, a press release, and a fact sheet on the Medicare Shared Savings Program changes  in the CY 2026 PFS final rule.    
 
Staff contact: mcarland@mehca.org

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