Some good news for primary care: the 2026 Medicare physician
fee schedule

If you have been following health care news lately, you may have heard about something called the Medicare physician fee schedule. While it might sound technical—and, truth be told, it is—it could not be more important to you as a family physician, whether you are running your own practice or working for a practice. 

The Medicare physician fee schedule is how the federal government determines how much physicians are paid for the care they provide to patients covered by Medicare Part B. Each year, the Centers for Medicare & Medicaid Services (CMS) updates this schedule, which affects millions of patients and the physicians who care for them.

While that might sound like an issue only for Medicare patients, the impact reaches much further. Payment rates set by Medicare set the trend for what other insurers, such as Tricare, Medicaid and private health plans, end up paying you for providing care. That means the Medicare fee schedule plays a central role in shaping the entire health care system, from your local clinic to hospitals nationwide.

Why Medicare payment matters

Family physicians care for people of all ages and backgrounds, but when Medicare payments do not match the real costs of running a practice, including staff, technology and supplies, it strains the entire health care system.

Inadequate payment rates make it harder for practices, especially small or independent ones, to stay open and serve their communities. It also discourages new physicians from entering primary care at a time when our nation needs more family doctors, not fewer.

The 2026 Medicare physician fee schedule brings good news

Thankfully, CMS gave us a lot to celebrate this year, and the provisions in the 2026 final rule reflect growing recognition of the vital role primary care plays in improving health and reducing costs.

The most notable improvements include:

• Payment rates have been updated to better match what it truly costs to care for patients today.

• Fairer payment calculations will recognize gained efficiencies over time in how physicians provide certain services, which supports increases in payment for services like evaluation and management (E/M).

• Payment policies will reflect the higher cost of doing business for small and independent practices.

• Family physicians can now use the G2211 add-on code in more situations, like home and residence E/M services, which supports the additional complexity that is inherent to the longitudinal relationships between patients and their primary care physicians.

• There is more help for integrating mental and behavioral health care, with new add-on codes that can be billed with advanced primary care management services and will make it easier for practices to connect patients with these important services.

Congress must do its part to help practices thrive

While these updates are a step in the right direction, it is important to note that most of the payment increases for 2026 are temporary and will expire at the end of next year. Without congressional action, practices could again face steep cuts in 2027.

That is why the AAFP continues to call on Congress to act. We need long-term, bipartisan reform:

• Establish an annual inflationary adjustment for Medicare physician payments.

• Level the playing field so all types and sizes of practices can thrive.

• Protect access to care for patients across the country.

It is about putting our patients and primary care first

To truly achieve the promise of a better health care system, we must prioritize primary care. The 2026 Medicare physician fee schedule moves us closer to that goal. But lasting change requires sustained commitment from policymakers and continued advocacy from physicians.

We remain steadfast in our mission: standing up for family physicians, protecting the sustainability of primary care and ensuring that every patient, no matter where they live, can access the trusted, ongoing care they need.