Main Library
The 2026 Medicare Physician Fee Schedule Final Rule is Here
The 2026 Medicare Physician Fee Schedule (MPFS) Final Rule is out and you’re wondering what it means for you. It’s packed with finalized updates on MIPS, six new MVPs, easier ACO reporting, a new program model, and acknowledgment of the extensive feedback received on multiple RFIs.
We’ll walk you through the highlights of what’s now official and show you how a QCDR like Patient360 can help you navigate these changes.
Breaking Down the CY 2026 CMS-1832-F Final Rule
The Centers for Medicare & Medicaid Services (CMS) has dropped its Medicare Physician Fee Schedule Final Rule for 2026, and, as usual, it’s a hefty one. This Final Rule, officially known as CMS-1832-F, outlines significant changes to the Physician Fee Schedule (PFS), the Quality Payment Program (QPP), and the Medicare Shared Savings Program (MSSP). It’s important to understand how these changes will affect your practice, your reporting, and ultimately, your revenue.
The Medicare PFS Final Rule is over 1,800 pages, so let’s break down some key areas.
Key Takeaways
- The MIPS performance threshold is finalized to remain at 75 points for 2026. (CMS did not finalize the multi-year proposal, reverting to annual rulemaking for 2027 and beyond).
- The transition from Traditional MIPS to MIPS Value Pathways (MVPs) continues, with CMS finalizing six new MVPs and changes to the inventory.
- Other MVP-related policies have been finalized, including changes to the registration process whereby multispecialty groups will split into subgroups through self-attestation, while small multispecialty groups can maintain their small group status.
- The Quality and Improvement Activities categories will see several finalized additions, removals, and changes.
- A new policy for the Cost category was finalized: new cost measures will have a two-year informational-only feedback period before being scored.
- Modest Promoting Interoperability changes were finalized, including modifications to the EHR SAFER Guide measure, suppression of the Electronic Case Registry requirement, and a new optional bonus measure.
- If you’re in an ACO, CMS finalized several minor but important changes, giving you more time to focus on improving quality measure reporting and adjusting to the APP program.
- CMS is launching a new program called the Ambulatory Specialty Model (ASM), which will indeed start with Performance Year 2027.
- CMS acknowledged extensive feedback received through RFIs on topics like FHIR rollout, the PDMP measure, and well-being measures, which will inform future rulemaking.