This episode of PYA's Healthcare Regulatory Roundup examines the 2026 Medicare Physician Fee Schedule Final Rule and its impact on physician reimbursement, payment calculations, and quality reporting. The discussion covers updates to the conversion factor under MACRA, budget neutrality adjustments, new efficiency adjustments affecting work RVUs, and revisions to the practice expense methodology.The presenters also review finalized changes to MIPS quality, cost, and interoperability requirements, along with the introduction of the mandatory Ambulatory Specialty Model beginning in 2027. The episode concludes with considerations for physician practices and healthcare organizations as they evaluate compliance obligations and reimbursement impacts under the final rule.

Presented by Martie Ross, Sarah Bowman, and Lori Foley on December 3, 2025.

Topics Covered:

• 2026 Payment Rate/Conversion Factor
• Efficiency Adjustment
• Practice Expense Methodology
• Ambulatory Specialty Model (new mandatory alternative payment model)
• Merit-Based Incentive Payment System (MIPS)
• Medicare Shared Savings Program (MSSP)