2026 MPFS Final Rule Released

November 12, 2025

On October 31, 2025, the Centers for Medicare & Medicaid Services (CMS) released the 2026 Medicare Physician Fee Schedule (MPFS) final rule, which includes payment provisions and policy changes to the Quality Payment Program (QPP) and Alternative Payment Model (APM) options and requirements for 2026. The final rule takes effect 1/1/26.

MPFS Key Proposals and Potential Medicare Reductions

The change to the MPFS conversion factor (CF) incorporates several factors: 

Beginning CY 2026 there will be two separate CFs resulting from the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA):

  • One for physicians participating in the Merit-based Incentive Payment System (MIPS) (where MIPS participants get a 0.25% payment update)
  • Another for physicians that are considered “qualifying participants” in an Advanced Alternative Payment Model (A-APM) (where qualifying participants receive a 0.75% update).
  • Also affecting the CF in CY 2026 are a budget neutrality adjustment of +0.49% and a +2.5% temporary increase for 2026 provided under the One Big Beautiful Bill Act (OBBBA). The OBBBA provisions expire on 12/31/26.

CMS finalizes its proposal to apply an efficiency adjustment of -2.5% to the work RVUs for non-time-based services. In addition, the agency finalizes significant updates to its practice expense methodology that it says will recognize greater indirect costs for practitioners in office-based settings compared to facility settings.

Read the 2026 MPFS Final Rule Summary. Click below to download the PDF.

About ZPAC: the Zotec Political Advocacy Committee (ZPAC), dedicates itself to making a difference for physicians and healthcare administrators nationwide. ZPAC advocates for equitable access to healthcare services for all individuals. Stay informed and engaged with ZPAC by following our podcast episodes, blog posts, and speaking engagements on our active Twitter/X and LinkedIn profiles. Together, we can shape policies that support healthcare providers and promote equitable access to quality care for all. To learn more about Zotec Partners, visit our website here.

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