CMS Proposes 2026 Medicare Physician Pay Updates, Tightening Rules on Part B Drug Price Penalties
Scores run from -100 (strongly harmful) to +100 (strongly beneficial) for each group, combining impact, certainty, scope, and duration ratings of 1-5. How impact scoring works
Locum tenens physicians and other clinicians who work across multiple settings benefit from the permanent expansion of telehealth flexibility, including simplified telehealth service list criteria and the ability to provide virtual direct supervision for most non-surgical services. These changes make it easier for physicians to work remotely and across geographic areas, supporting flexible practice arrangements.
CMS finalized a 2026 pay rule increasing physician reimbursement by 3.77% for value-based providers and 3.26% for others. While top-line rates rise due to the 'One Big Beautiful Bill Act,' new efficiency adjustments and site-of-service payment changes may result in net cuts for hospital-based docs.
The final rule confirms that beginning in 2026, Medicare will use separate conversion factors for clinicians in Advanced APMs ($33.57) versus others ($33.40). It also clarifies ASP reporting for drugs sold at a Maximum Fair Price and updates the Medicare Prescription Drug Inflation Rebate Program.
Document Type
Federal Rule
Official Title
Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
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