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

Why This Topic Matters

The final rule affects how Medicare payment amounts are set for many services in 2026 and highlights meaningful differences between facility and non-facility reimbursement. It also includes policy changes that may affect participation, reporting, and planning under QPP and MSSP.

Article Sections

1. New in 2026: 2 conversion factors

   Overview of the finalized 2026 Medicare conversion factor structure and the broad annual changes affecting physician and anesthesia payment rates.

2. But watch the RVU inputs

   Discussion of broader RVU-related adjustments, including site-of-service effects and the efficiency-related changes that influence payment projections by specialty and setting.

3. QPP, Shared Savings changes mostly intact from proposed

   Summary of finalized Medicare quality and shared savings policy updates, including program structure, eligibility, reporting, and measure-set changes.

4. Impact on CY 2026 payment for selected procedures

   Illustrative payment impact table for selected procedures and services across facility and non-facility settings for 2025 and 2026.