Breaking: CMS finalizes fee disparity between facility and non-facility, sets two conversion factors

Why This Topic Matters

The final rule affects how Medicare physician services will be paid in 2026, with differences tied to site of service and participation in qualifying APMs. Practices and revenue cycle teams may need to understand the broad payment changes and program updates that could affect reimbursement, quality reporting, and participation strategies.

Article Sections

1. New in 2026: 2 conversion factors

   Overview of the finalized conversion factor structure for 2026 and how CMS distinguishes payment updates for qualifying APM participants versus others.

2. But watch the RVU inputs

   Discussion of broader relative value unit and practice expense changes, including site-of-service differences and projected impacts on specialty reimbursement.

3. Impact on CY 2026 Payment for Selected Procedures

   Table of selected high-volume services showing projected payment changes by setting for the 2026 fee schedule.

4. QPP, Shared Savings changes mostly intact from proposed

   Summary of finalized policy updates affecting the Quality Payment Program, Medicare Shared Savings Program, APM participation, and related reporting initiatives.