AHA comments on CY 2026 physician fee schedule final rule 

The AHA commented Nov. 3 on the Centers for Medicare & Medicaid Services’ calendar year 2026 final rule for the physician fee schedule. The rule, released Oct. 31, increases the qualifying alternative payment model participant conversion factor by 3.77% in CY 2026 as compared to CY 2025. It increases the non-QP conversion factor by 3.26% in CY 2026 as compared to CY 2025. These updates include statutory updates of 0.75% and 0.25% for the QP and non-QP factors, respectively; another statutory update of 2.5% as required by the One Big Beautiful Bill Act; and an increase of 0.49% that CMS states is necessary to account for changes in the work relative value units. 

In a statement shared with media, Ashley Thompson, AHA senior vice president of public policy analysis and development, said, “The AHA is pleased that CMS, as directed by Congress, finalizes a positive payment update for physicians for CY 2026. However, we are disappointed that the agency also finalizes the proposed efficiency adjustment and changes to the practice expense methodology, which both redistribute payments and disadvantage certain providers, including hospital-based physicians. We remain concerned about the overall inadequacy of Medicare physician payments and its impact on access to and quality of care. We also applaud CMS for extending or making permanent certain telehealth flexibilities, which are needed now more than ever to ensure patients’ continued access to high-quality care.”