ICYMI — CMS Releases Medicare PFS Final Rule with -2.5% ‘Efficiency Adjustment’

The Centers for Medicare and Medicaid Services (CMS) finalized the CY2026 Medicare Physician Fee Schedule on October 31. Most physicians, depending on their mix of services, will see no increase in Medicare reimbursement next year, with many specialties taking a payment cut due to a new -2.5 percent “efficient adjustment.” Physicians who provide services in a facility will experience the steepest cuts because of practice expense rebasing, which creates significant site-of-service shifts. Payment for office-based services will increase, while payment for services provided by physicians in hospital outpatient departments and ambulatory surgery centers will be reduced. The policy does not distinguish between hospital-employed physicians and those in independent practice who incur overhead costs when they provide services in the hospital. More details are available here. 

CAPITOL ROUNDS NOVEMBER 2025