2026 Physician Fee Schedule: A Practical Guide to Key Changes

1. Two Conversion Factors in 2026

To start, Medicare will use two separate conversion factors in 2026. One applies to clinicians in certain value-based models, and the other applies to everyone else. 

This means reimbursement will differ based on a provider’s participation status.

Although this sounds complex, it becomes manageable when your system can model these differences for you. Because of this, many clinics are already reviewing how their most common CPT codes may change next year.

For a simple explanation, you can also read the summary on Physicians Practice recent article here: 8 Big Takeaways from the 2026 Medicare Physician Fee Schedule.

2. Some Payment Adjustments Are Expected

Centers for Medicare & Medicaid Services (CMS) also plans modest adjustments to certain services. Some procedures may see slight decreases based on efficiency updates. Others may experience small increases.

These changes are not unexpected. Still, they can quickly create confusion if your billing system doesn’t update promptly. Therefore, reviewing your top codes early helps avoid reimbursement delays.

This is why many practices are reviewing their top codes now, so they can enter 2026 with clear expectations.

3. Telehealth Flexibility Remains Strong

Telehealth continues to play a major role in care. The 2026 schedule supports this by keeping flexible rules in place for virtual supervision and remote services.

This is good news. It helps practices expand access while keeping operations efficient. Just make sure your EHR or PM keeps telehealth billing rules current and easy to follow.

4. New Codes for Integrated and Behavioral Care

CMS also introduced several new add-on codes supporting coordinated and behavioral health services. These codes help practices capture the true value of the care they provide.

Although these additions bring new revenue opportunities, they also require updated documentation templates and billing workflows. This is where the right software makes a difference.

How The Right Solution Helps Practices Prepare for 2026

While knowing the changes are important, the biggest challenge for most practices is managing fee schedules and billing rules. CureMD along with their partner, Virtual OfficeWare, offer several advantages that help practices stay ahead without extra effort.

CureMD Advantage #1: Direct Fee Schedule Loading

Many systems rely on third-party clearinghouses to update or load fee schedules. This slows everything down.

CureMD is different.

Unlike many systems, CureMD allows your team to load the 2026 Medicare fee schedule directly into the Practice Management or EHR system.
First, there’s no waiting.
Second, no outside vendors.
Third, there are no delays.

Therefore, this means your schedules stay accurate, updated, and ready well before the new year begins.

CureMD Advantage #2: AI-Driven Billing + Clearinghouse Rules

In addition, the AI-driven billing engine works side-by-side with clearinghouse rules.
As a result:

• Claims are cleaner
• Errors are caught sooner
• Rejections drop
• First-pass rates increase

This combined rules engine helps your team send claims that are correct the first time, which improves cash flow and reduces back-and-forth work.

CureMD Advantage #3: Simple Tools for a Complex Year

With changing conversion factors, new codes, and shifting telehealth policies, clinics need software that keeps things simple. CureMD gives practices clear visibility into expected revenue, coding updates, and documentation needs, all inside one platform.

As a result, when systems stay organized, staff remain focused, workflows run smoothly, and reimbursements arrive faster.

How to Prepare for the 2026 Medicare Physician Fee Schedule

Here are a few easy steps your practice can take now:

1. Review your top CPT codes. See how upcoming changes may impact your revenue.
2. Strengthen your workflow. Update any outdated processes before January.
3. Train your team. Ensure your staff understands the new codes and billing rules.
4. Evaluate your software. If your system cannot keep up, now is the time to upgrade.
5. Monitor CMS updates. Changes may continue throughout the year.

For additional help and healthcare business insights, you can also visit: www.vowhs.com

Final Thoughts on your 2026 Medicare Fee Schedule Transition

In summary, the 2026 Medicare Physician Fee Schedule brings meaningful changes, but with the right preparation and the right technology, practices can move into the new year with confidence.

CureMD’s direct fee schedule loading, advanced AI billing tools, and powerful clearinghouse integration make it easy to:

• Stay compliant
• Streamline billing and
• Improve first-pass rates

Now is the perfect time to get ahead. Schedule a walkthrough of this all-in-one billing and EHR solution today to see how smoothly your practice can transition into 2026.