2026 Medicare Fee Schedule
The 2026 Medicare Fee Schedule is out. Here's what practice leaders need to know.
The headlines say 3.26% increase. Sounds great, right? Not so fast.
CMS made a major change to site-of-service payment:
→ Facility-based services: DOWN 7%
→ Office-based services: UP 4%
Plus, a 2.5% "efficiency adjustment" cut hitting 91% of services.
What should you do right now?
Know if your providers are in MIPS or an Advanced APM (different rates apply).
Pull your top Medicare CPT codes and model the ACTUAL impact for your practice. Don't rely on specialty averages. Your specific code mix determines your outcome. And if you have contracts based on a percentage of CMS, model those, too!
A practice that's 80% office-based will see a very different result than one that's 80% facility-based, even in the same specialty.
Do the math.
Use YOUR codes.
Know YOUR numbers.
Check out the CMS Fact Sheet.