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  • MGMA Washington Update 1/8/2-26

    08 Jan 2026 8:45 AM | Kristina (Administrator)

    Medicare Part B Updates for 2026

    The Centers for Medicare & Medicaid Services (CMS) made numerous changes to Medicare Part B in the 2026 Medicare Physician Fee Schedule. CMS recently released RVU files that include the two newly introduced conversion factors for 2026: one file contains the conversion for qualifying APM participants (QPs), while the other file includes the conversion factor for non-QP participants. 

    See MGMA Government Affairs’ Medicare Outlook Webinar for more information about what is changing in Medicare for 2026, along with our Analysis of 2026 Medicare Physician Fee Schedule Final Rule.

    Medicare Telehealth Extension and Upcoming Expirations

    The Drug Enforcement Administration (DEA), in coordination with the Department of Health and Human Services, issued an extension of COVID-era telemedicine flexibilities for prescribing controlled medications through December 31, 2026, which were previously set to expire on December 31, 2025. This extension is intended to give the DEA time to finalize telemedicine prescribing regulations to ensure a smooth transition for patients and providers. Absent Congressional action, other COVID-era Medicare telehealth flexibilities will expire on January 30, 2026, including:

    • The ability to see a patient in their home, regardless of geographic location
    • An expanded list of eligible practitioners

    MGMA has long advocated for expanding coverage and reimbursement of virtual services to increase patient access to care. Contact your congressional representatives and urge them to extend these telehealth flexibilities and work toward a permanent solution.

    HHS Proposes to Streamline the Health IT Certification Program and Seeks Input on AI

    At the end of December 2025, HHS released two important health information technology policy documents for medical group practices. One seeks general input on how HHS can accelerate the adoption and use of artificial intelligence in clinical care, while the other proposes specific regulatory changes affecting interoperability and the Health IT Certification Program, including streamlining the certification requirements of electronic health records and adjusting certain information blocking policies. MGMA is reviewing these to understand their impact on medical group practices and to inform its advocacy. Members are encouraged to share input by contacting govaff@mgma.org.


  • CMS Releases Update on Processing Medicare Claims Impacted by the Government Shutdown

    26 Nov 2025 10:53 AM | Kristina (Administrator)

    CMS released an update on its processing of Medicare claims, which were impacted by the government shutdown and recent legislation that extended many healthcare policies that had expired at the end of September. This follows an earlier CMS FAQ discussing the extension of telehealth flexibilities. 

  • CMS Releases OPPS/ASC Payment System Final Rule

    26 Nov 2025 10:51 AM | Kristina (Administrator)

    CMS released the 2026 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule, which finalized many of the proposed policies, such as:

    • Increasing payment by 2.6% for hospitals and ASCs that meet relevant quality reporting requirements
    • Eliminating the inpatient only (IPO) list over a 3-year period, beginning with the removal of mostly musculoskeletal procedures for CY 2026
    • Revising the ASC covered procedure list (CPL) criteria, which results in hundreds of new procedures being added to the ASC CPL
    • Updating skin substitute reimbursement policies to align with skin substitution categorization consistent with the FDA, and establishing a single payment rate for CY 2026
    • Creating stricter price transparency requirements



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