Heads Up: CMS Work RVU Changes Coming in 2026

If you haven't heard about this one yet, it's time to put it on your radar.

Starting in 2026, CMS is implementing a -2.5% efficiency adjustment to work RVUs for non-time-based services. Their reasoning? Providers have become more efficient over time due to technology and experience. Whether you agree or not, it's happening.

Over 7,000 codes are affected, primarily radiology, procedures, and diagnostic tests. Time-based codes like E/M, telehealth, care management, and behavioral health services are exempt.

Here's the part that matters most: if your practice uses RVU-based provider compensation, take a close look now. When work RVU values drop, providers doing the same work will show lower "productivity" on paper and potentially earn less, even though their effort hasn't changed. That's a tough conversation to have after the fact.

My advice? Pull your contracts, model out the impact on your most common non-time-based codes, and decide if adjustments are needed before 2026 arrives. Options include adjusting compensation rates, adding quality metrics, or moving toward a blended model. And remember, any changes still need to meet Stark and Anti-Kickback requirements.

A little planning now saves a lot of headaches later.