decisionhealth Newsletters, Part B News - 2025 Issue 11 (November)
Non-facility setting favored in practice expense RVU revamp
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Article Overview
This article covers CMS’s 2026 Medicare physician fee schedule final-rule changes that reshape practice expense relative value unit payment methodology by site of service. It is aimed at physicians, coders, billers, and practice administrators who need to understand how facility and non-facility settings are being treated differently, where to locate the impact estimates, and what broad types of specialties and services may be affected.
Why This Topic Matters
The changes alter how physician fees are distributed across settings, which can affect reimbursement planning, service location strategy, and fee schedule analysis for 2026.
Article Sections
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Physician payments
Introduces the 2026 fee schedule context and the broader shift in how payment inputs are being adjusted based on site of service.
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Where to find the expected impact
Points readers to the final-rule table that summarizes projected effects and notes the categories of specialties seeing changes across settings.
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RVU changes net mixed reviews
Summarizes stakeholder feedback on the proposed methodology and CMS’s response to the comments received.
What You Will Learn
- How CMS is changing payment methodology for physician services by site of service
- Where the final rule presents projected impact information
- What general types of specialties and service settings are discussed in the final rule
- How stakeholder comments and CMS responses frame the policy change
Who Should Read This
- Physicians
- Medical coders
- Medical billers
- Practice administrators
- Revenue cycle staff
- Healthcare compliance teams
Codes Discussed
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