Doc Groups Say Proposed Medicare Payment Increase Is Inadequate
UNITED STATES, JUL 15 – CMS proposes a 3.62% increase in physician payments and introduces a new Ambulatory Specialty Model to improve care quality and reduce Medicare spending waste, saving $280 million.
- The U.S. federal agency overseeing Medicare and Medicaid programs has proposed the 2026 Medicare Physician Fee Schedule, which includes introducing a new Ambulatory Specialty Model aimed at enhancing heart failure care starting in January 2027.
- The proposal addresses the dramatic rise in Medicare expenses for skin substitutes, which grew from a few hundred million dollars in 2019 to several billion dollars by 2024, a surge largely attributed to exploitative pricing strategies.
- The rule proposes different payment rates based on whether clinicians participate in designated alternative payment models, seeks to minimize wasteful spending, enhances chronic disease management, and updates quality measurement criteria.
- The qualifying APM conversion factor will increase by $1.24 to $33.59 and the nonqualifying by $1.17 to $33.42, reflecting a 2.5% base rate hike mandated by recent budget legislation.
- Physician groups welcomed the modest payment increase but criticized it as underwhelming amid years of underpayment that threaten patient access and private practice sustainability.
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CMS Eyes 3.8 Percent Pay Hike for Doctors, Medicare Cost Cuts, and Chronic Care Expansion - The Thinking Conservative
Trump admin plan will save billions on wasteful spending, boost rates for doctors, and modernizing Medicare services, said HHS Sec. RFK, Jr. The post CMS Eyes 3.8 Percent Pay Hike for Doctors, Medicare Cost Cuts, and Chronic Care Expansion appeared first on The Thinking Conservative.
CMS Eyes 3.8 Percent Pay Hike for Doctors, Medicare Cost Cuts, and Chronic Care Expansion
The Trump administration has proposed changes to Medicare’s physician payment rates that could boost doctor pay by as much as 3.8 percent in 2026 while aiming to crack down on wasteful spending and expand chronic disease prevention programs. Under the proposed Medicare Physician Fee Schedule (PFS) for calendar year 2026, the Centers for Medicare & Medicaid Services (CMS) said on July 15 that it would increase the conversion factor—a key componen…
MedPage Today
Anti-Aging, Acupuncture and Health NewsDoc Groups Say Proposed Medicare Payment Increase Is Inadequate
(MedPage Today) -- Some physician groups are unhappy with the proposed changes to the Medicare Physician Fee Schedule for 2026 that the Centers for Medicare & Medicaid Services (CMS) announced Monday. The fee schedule update varies depending...
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