Last week the Centers for Medicare & Medicaid Services (CMS) published the 2026 Medicare Physician Fee Schedule (PFS) final rule. 2026 outpatient and ASC rates are expected to be released within 4 weeks, delayed due to the government shutdown. The following is a summary of finalized payment policies in the final rule:
The Trump administration is implementing extraordinary changes in 2026 to how Medicare physician payments are calculated. CMS is finalizing a new negative productivity adjustment, called the “Efficiency Adjustment” to cut the intraservice time of the work RVUs by 2.5%. This adjustment applies to all codes except time-based codes, such as evaluation and management (E/M) services, care management services, behavioral health services, services on the Medicare telehealth list. In all, final 2026 Rates for 27130 & 27447 will be lowered by 7.3% for Qualifying APM Participants and 7.8% for Non-Qualifying APM Participants. For more detail, read our summary.
AAHKS continues to pursue every avenue of advocacy with Congress and CMS to restore fair reimbursement for arthroplasty procedures and stop any further erosion in what our members receive for the valuable work they do for their patients.
