Navigating the 2026 CMS Proposed Physician Fee Schedule: What You Need to Know

Description

“Are You Ready for the 2026 CMS Fee Schedule? Join Our Expert-Led Webinar”
Big changes are coming to Medicare reimbursement in 2026. Join us for a 60-minute breakdown of the CMS Proposed Physician Fee Schedule—what’s changing, what it means for your practice, and how to prepare.

Key Themes in the 2026 Proposed Rule (as of July 2025):-

Conversion Factor Pressure Continues:-

• The conversion factor (CF) is expected to decline again in real terms due to budget neutrality and lack of inflationary updates.
• Despite short-term legislative fixes, structural issues from MACRA and sequestration persist.

Coding & Payment Trends:-

• G2211 (complexity add-on code) is gaining traction but still underutilized compared to projections.
• Remote Patient Monitoring (RPM) and Principal Illness Navigation (PIN) services are growing, but reimbursement rates are lagging behind utilization.
• Social Determinants of Health (SDOH) codes are being used more frequently, though their long-term viability may depend on future policy direction.

Practice Expense & Technology Misalignment:-

• CMS acknowledges that the current practice expense methodology doesn’t account for digital tools like AI, software, or algorithms.
• No formal policy fix yet, but this could affect how tech-enabled services are reimbursed.

MIPS & Quality Payment Program (QPP):-

• MIPS Value Pathways (MVPs) are being positioned as the future of QPP.
• CMS is reportedly scaling back equity-focused quality measures, signaling a shift in policy priorities.

Learning Objectives:-

By the end of the webinar, attendees will be able to:

• Identify major changes proposed in the 2026 CMS PFS
• Understand the impact on reimbursement, conversion factors, and RVUs
• G2211 utilization and remote monitoring services
• Prepare actionable strategies for compliance and revenue cycle adaptation

Areas Covered:-

• Prepare for continued reimbursement compression unless Congress intervenes.
• Monitor G2211, RPM, and PIN utilization trends to align with CMS priorities.
• Reassess denial management and appeals strategies in light of shifting documentation and coding expectations.
• Stay engaged during the comment period to advocate for sustainable payment reform.

Who Should Attend?

• Healthcare administrators, medical coders, compliance officers, physicians, and billing professionals
• Policy analysts, consultants, healthcare attorneys