Description 

The 2026 CMS Physician Fee Schedule Proposed Rule signals continued reductions in the conversion factor, a shifting landscape toward value-based care, and critical coding revisions that may impact your revenue, workflow, and compliance posture.

Big changes are coming to Medicare reimbursement in 2026. Join us for a 60-minute breakdown of the CMS Proposed Physician Fee Schedule—what’s changing, what it means for your practice, and how to prepare.

Session Highlights

This session delivers a comprehensive analysis of the 2026 CMS PFS Proposed Rule and how it may reshape reimbursement, coding practices, and compliance requirements in the year ahead. Key discussion areas include:

• Conversion Factor Pressure Continues

1. The conversion factor (CF) is expected to decline again in real terms due to budget neutrality and lack of inflationary updates
2. Despite short-term legislative fixes, structural issues from MACRA and sequestration persist

• Coding and Payment Trends

1. G2211 (complexity add-on code) is gaining traction but remains underutilized compared to projections
2. Remote Patient Monitoring (RPM) and Principal Illness Navigation (PIN) services are growing, but reimbursement rates are lagging behind utilization
3. Social Determinants of Health (SDOH) codes are seeing increased use, though their long-term viability may hinge on future policy direction

• Practice Expense and Technology Misalignment

1. CMS acknowledges the current practice expense methodology fails to account for digital tools such as AI, software, or algorithms
2. No formal policy fixed yet, but this could influence future reimbursement for tech-enabled services

• MIPS and Quality Payment Program (QPP)

1. MIPS Value Pathways (MVPs) are being positioned as the future of QPP
2. CMS appears to be scaling back equity-focused quality measures, signaling a shift in policy priorities

Learning Objectives

By the end of this webinar, attendees will be able to:

• Identify major changes proposed in the 2026 CMS PFS
• Understand the impact on reimbursement, conversion factors, and RVUs
• Monitor G2211, RPM, and PIN utilization trends to align with CMS priorities
• Prepare actionable strategies for compliance and revenue cycle adaptation

Areas Covered

• Prepare for continued reimbursement compression unless Congress intervenes
• Monitor G2211, RPM, and PIN utilization trends to align with CMS priorities
• Reassess denial management and appeals strategies in light of shifting documentation and coding expectations
• Stay engaged during the comment period to advocate for sustainable payment reform

Who Should Attend

• Healthcare administrators and practice owners
• Medical coders and documentation specialists
• Compliance officers, revenue cycle managers, and billing professionals
• Physicians, clinical directors, and health system executives
• Consultants, policy analysts, healthcare attorneys, and CPAs