decisionhealth Newsletters, Coder Pink Sheets - 2025 Issue 7 (July)
Proposed fee schedule: Expect big pay jump for E/M services in non-facility settings
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Article Overview
This article examines proposed 2026 Medicare physician fee schedule updates for non-facility evaluation and management services. It is aimed at coders, billing professionals, and practices that track Medicare payment policy, and it summarizes the broad payment outlook, the basis for year-to-year comparison, and the proposed conversion factors used in the analysis.
Why This Topic Matters
Payment changes in Medicare physician fee schedules can affect reimbursement planning, coding workflows, and revenue projections for offices and other outpatient settings. This article helps readers understand the scope of the proposed changes and where to look for service categories that may be affected.
Article Sections
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Overview of proposed 2026 payment changes
Introduces the proposed Medicare fee schedule changes and the non-facility service categories covered by the analysis.
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Selected E/M fee outlook: A year-to-year comparison
Presents a comparative fee analysis for office and other outpatient evaluation and management services using proposed 2026 payment assumptions.
What You Will Learn
- What the article covers in the proposed 2026 Medicare physician fee schedule
- Which general non-facility service categories are included in the payment comparison
- How the article frames year-to-year fee trend analysis
- Which broad factors are discussed as influencing proposed payment changes
Who Should Read This
- Medical coders
- Billing and reimbursement staff
- Practice administrators
- Physician groups
- Healthcare finance professionals
Codes Discussed
Code Ranges Discussed
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