CY 2026 Physician Fee Schedule Final Rule Summary – Part I

On November 5, 2025, CMS published in the Federal Register (90 FR 49266) a final rule relating to the Medicare physician fee schedule (PFS) for CY 2026 and other revisions to Medicare Part B policies. Policies in the final rule generally would take effect on January 1, 2026. HFMA is providing a summary in three parts. Part I covers sections I through III.G (except for Section III.F: Medicare Shared Savings Program Requirements) and the Regulatory Impact Analysis. Part II will cover the Medicare Shared Savings Program Requirements. Part III will cover the updates to the Quality Payment Program. Part I includes payment policies under the PFS including determining relative values for physician work, practice expense, and malpractice, evaluation and management services, telehealth services, enhanced care management services, global surgery payment, behavioral health services, dental services, skin substitute payment, geographic practice cost indices, and Inflation Reduction Act provisions relating to Part B drugs and biologicals. The final rule also included comment solicitations on strategies for improving global surgery payment accuracy, policies to improve care for chronic illness and behavioral health needs, payment for services in urgent care centers, and payment policy for software as a service.