CMS Proposes 2026 Medicare Pay Boost, Permanent Remote Imaging, and Chronic Care Overhaul

The Centers for Medicare & Medicaid Services (CMS) issued its proposed 2026 Medicare Physician Fee Schedule, offering a 3.6% pay hike for most physicians and a 3.83% increase to physicians in eligible Alternative Payment Models (APMs). This is a significant shift following several years of zero or reduced reimbursement rates.

The conversion factor will increase from $32.35 to $33.42 for non-APM participants and to $33.59 for APM participants. These reflect a statutory 2.5% increase under the "Big Beautiful Bill," an additional 0.55% change for work RVU changes, and MACRA-mandated adjustments.

One of the significant wins for radiology and for rural healthcare is the permanent institution of distant imaging supervision under real-time audio/video technology. The flexibility, first established during the COVID-19 pandemic, will become a standard in Medicare policy.

CMS also proposes the Ambulatory Specialty Model, an optional five-year model for heart failure and low back pain. Specialists will be incentivized by early intervention and care coordination, hoping to reduce hospitalizations and enhance outcomes.

But danger signals persist. Cardiologists warn that a 27% cut in reimbursement for transcatheter left atrial appendage occlusion procedures could price high-value stroke-prevention services out of patients' reach. CMS also suggests an unpopular 2.5% "efficiency adjustment" in non-time-based services, which some physician groups argue could unfairly penalize procedural specialties.

The proposal includes expanded telehealth benefits, streamlined quality measures to prevent chronic disease, and wasteful spending reduction—namely on skin substitutes, which CMS aims to reclassify for reducing costs by 90%.

Comment on the proposed rule is accepted through September 12, 2025.