The amount Medicare pays per RVU gets its first substantial boost in years, but most of the increase will expire at the end of 2026 unless Congress acts.
Fam Pract Manag. 2026;33(1):25-31
Author disclosures: no relevant financial relationships.
The old Yogi Berra aphorism “a nickel ain’t worth a dime anymore” might resonate with many physicians these days. The Medicare Physician Fee Schedule’s (MPFS) budget neutrality requirements combined with a lack of any updates to account for inflation have created a Medicare payment system that hasn’t kept pace with the rising costs of running a practice.
While a lasting solution remains elusive, the 2026 MPFS final rule provides some temporary relief and signals that the Centers for Medicare & Medicaid Services (CMS) is prioritizing primary care.1 For example, the final rule includes an increase in the Medicare conversion factor, many common primary care codes exempted from an “efficiency adjustment” cut, a practice-expense calculation change that favors care provided in offices versus facilities, and expanded use of code G2211.
KEY POINTS
The 2026 Medicare Physician Fee Schedule includes several provisions that should boost primary care, including an increase in the conversion factor and expanded use of G2211 for home and residence visits.
The Centers for Medicare & Medicaid Services also changed how it calculates practice expense RVUs in a way that increases payment for services provided in office settings while decreasing it for facility settings.
CPT added new codes that expand payment opportunities for remote monitoring and immunization counseling.
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