CMS’ Physician Payment Proposal is a Mixed Bag for GI

On July 14, the Centers for Medicare and Medicaid Services (CMS) released proposed payment rates for physician services for calendar year (CY) 2026. 

Here are the top takeaways: 

• Conversion factor increase: The “One Big, Beautiful Bill” that Congress passed on July 3 will increase the CY 2026 conversion factor to $33.42 for most physicians, a projected increase of $1.17, or 3.62%, from the current conversion factor of $32.35.
• Payment increases for office-based services, cuts for ASC/hospital-based services: Using new methodologies that CMS believes will benefit private practices, CMS is proposing changes to how physician practice expenses are calculated for office-based versus facility-based services. This is resulting in significant payment changes based on site of service.  

• New “efficiency adjustment” cuts RVUs for GI procedures: CMS proposes an “efficiency adjustment,” of –2.5% applied to work RVUs and procedure time at the code level because CMS believes clinicians become more efficient over time in performing procedures. “Efficiency” cuts would be applied every three years.
• Direct supervision via telehealth will continue: CMS proposes to make permanent that physicians may provide direct supervision remotely for procedures, except 010- and 090-day global codes.

The GI societies are conducting an in-depth review of the proposed policies to gauge the impact on GI. We will provide additional analysis about the rules, including MPFS and HOPD and ASC, in an upcoming alert with updates on how the proposed rules will impact you and how to get involved.

Resources 

Physician Fee Schedule

2026 Physician Fee Schedule Proposed Rule

2026 Physician Fee Schedule Proposed Rule Press Release

2026 Physician Fee Schedule CY 2026 Proposed Rule Fact Sheet

2026 MPFS Proposed Rule GI and E-M Payment Changes

2026 MPFS Proposed Rule Work and Practice Expense RVU Changes