decisionhealth Newsletters, Part B News - 2025 Issue 8 (August)
Expect big pay jump for E/M services in non-facility settings
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Article Overview
This article covers proposed 2026 Medicare physician fee schedule updates affecting a broad set of non-facility evaluation and management services. It is intended for coding, billing, and reimbursement professionals who want to understand which service categories are included, how proposed conversion factors affect payment, and how selected high-volume services compare year over year.
Why This Topic Matters
The article helps readers track proposed Medicare payment shifts that could affect reimbursement planning, service mix, and budgeting for office-based and other non-facility E/M work.
Article Sections
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Overview of proposed 2026 payment changes
Introduces the scope of the proposed Medicare physician fee schedule update and the types of non-facility E/M services included in the analysis.
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Selected E/M fee outlook: A year-to-year comparison
Presents a comparative table of selected services across current and proposed payment periods, including separate conversion factor scenarios and year-over-year percentage change.
What You Will Learn
- Which broad non-facility E/M service categories are included in the proposed Medicare fee schedule analysis.
- How the article frames the comparison between current-year and proposed 2026 payment amounts.
- What service groups are highlighted as having notable year-to-year payment changes.
- How proposed conversion factors are presented in relation to payment comparisons.
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Practice managers
- Compliance staff
- Physician administrators
Codes Discussed
Code Ranges Discussed
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