CMS Releases 2026 Medicare Physician Fee Schedule Final Rule

This article was updated Nov. 7 with the detailed summary of the MPFS final rule as well as information regarding the Quality Payment Program. 

CMS released the 2026 Medicare Physician Fee Schedule (MPFS) final rule with two fact sheets related to the 2026 MPFS and Medicare’s Shared Savings Program October 31. In this rule, CMS describes changes to Medicare payment provisions and to policies for the ninth year of the Quality Payment Program (QPP) and its component participation methods — the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). ACR^® created a detailed summary of the provisions of the final rule that have a direct impact on imaging services.

The conversion factor for services provided by a qualifying APM participant is finalized at $33.5675, inclusive of a .75% annual update. Services provided by non-APM participants have a conversion factor of $33.4009, which includes a .25% annual update. Both conversion factors also include a 2.5% one year increase to the MPFS conversion factor included in the budget reconciliation bill, as well as a .49% budget neutrality adjustment.

CMS estimates an overall impact of the MPFS changes to be -2% for radiology, -1% for nuclear medicine, 2% for interventional radiology and -1% for radiation oncology under the finalized fee schedule.

Under the Quality Payment Program, CMS finalized new Diagnostic and Interventional Radiology Merit-based Incentive Payment System Value Pathways with relevant clinical and measures and activities. Key radiology measures will retain the adjusted scoring methodology. The Achieving Health Equity subcategory was removed from the Improvement Activity category, while new activities are being introduced under other subcategories. CMS also updated cost attribution rules for the Total Per Capita Care Cost measure and introduced a new benchmarking method for claims-based measures.

For questions about the final rule, contact Angela Kim, ACR Senior Director of Economic Policy.