The Centers for Medicare & Medicaid Services has issued the calendar year 2026 Medicare physician fee schedule final rule, outlining policy and payment changes that will take effect Jan. 1, 2026. The physician fee schedule governs payment for physician and other health professional services under Medicare Part B and serves as a policy framework for reimbursement, quality reporting, and coverage of telehealth and behavioral health services.
Key highlights
- CMS finalized two separate conversion factors — $33.57 for clinicians in qualifying alternative payment models and $33.40 for non-qualifying participants — representing a 3–4% increase from 2025.
- The agency also introduced an efficiency adjustment to work relative value units (–2.5%) for certain non-time-based services to account for productivity gains in clinical practice.
- CMS finalized the permanent removal of frequency limits for subsequent inpatient, nursing facility, and critical care visits.
- It also established a permanent virtual supervision policy, allowing real-time audiovisual supervision for incident-to, diagnostic, and rehabilitation services.
- Teaching physicians may continue to have a virtual presence for supervision when services are delivered virtually, making permanent a policy previously scheduled to expire in 2025.
The AASM will analyze the 2026 physician fee schedule final rule, in its entirety, for potential impact on sleep-specific services.
View the CMS fact sheet: Calendar Year 2026 Medicare Physician Fee Schedule Final Rule
Members may send questions about the final rule to coding@aasm.org.
