CY 2026 Physician Fee Schedule Proposed Rule Summary – Part I

On July 16, 2025, CMS published in the Federal Register (90 FR 32352) a proposed rule relating to the Medicare physician fee schedule (PFS) for CY 2026 and other revisions to Medicare Part B policies. If finalized, policies in the proposed rule generally would take effect on January 1, 2026. The 60-day comment period ends at close of business on September 12, 2025. HFMA is providing a summary in three parts. Part I covers sections I through III.G (except for Section II.H Outpatient Therapy Services and Section III.F: Medicare Shared Savings Program Requirements) and the Regulatory Impact Analysis. Part II will cover the Medicare Shared Savings Program Requirements. Part III will cover the updates to the Quality Payment Program. Part I includes payment policies under the PFS including determining relative values for physician work, practice expense, and malpractice, evaluation and management services, telehealth services, enhanced care management services, global surgery payment, behavioral health services, dental services, skin substitute payment, geographic practice cost indices, and Inflation Reduction Act provisions relating to Part B drugs and biologicals. The proposed rule also contains comment solicitations on strategies for improving global surgery payment accuracy, policies to improve care for chronic illness and behavioral health needs, payment for services in urgent care centers, and payment policy for software as a service.