Late on Friday, the Centers for Medicare and Medicaid Services (CMS) issued a
final rule establishing final payment rate under the Medicare Part B Physician Fee Schedule (PFS) and other policy updates for Calendar Year (CY) 2026. The rule will become effective for items and services beginning on January 1, 2026.
AHCA/NCAL has reviewed the final rule and developed a detailed
summary outlining key provisions and impacts on members.
Please note this is for members only and requires an AHCA/NCAL log-in to view. Key points from the final rule include:
- A 3.26 percent increase in the base conversion factor for Medicare Part B services such as outpatient therapy services furnished by SNF providers.
- Revised telehealth provisions that help to assure more timely and consistent AHCA/NCAL member resident access to medical services in their residence 24/7/365.
- Removal of all time-based outpatient therapy codes from the proposed efficiency adjustment list.
CMS has also shared a fact sheet about the final rule, a press release, and a fact sheet on the Medicare Shared Savings Program changes in the CY 2026 PFS final rule.