Executives at major health systems and physician groups are pushing back against the CMS proposed 2026 Physician Fee Schedule and changes to the Medicare Shared Savings Program, warning the updates fail to keep pace with rising costs and could cut payments for many specialties.
The 1,803-page proposal includes a 3.62% increase to $33.42 in Medicare physician pay, but also a 2.5% “efficiency adjustment” that would reduce work RVUs and intraservice time for thousands of non-time-based procedures.
Physician groups including the American Medical Association and the Medical Group Management Association argue the proposal deepens long-standing underpayment.
Both groups note that practice costs have risen steadily while inflation-adjusted Medicare pay has declined since 2001, and say budget neutrality rules worsen the problem by forcing cuts elsewhere whenever CMS increases payment for one service.
According to the AMA, when adjusted for inflation, Medicare physician payment has effectively declined 33% from 2001 to 2025. The AMA also notes that practice expense cuts and efficiency adjustments may disproportionately harm services done in facility settings, or specialties with high overhead.
Some specialties may face steep reductions. For example, oncology, internal medicine, OB-GYN and infectious disease may stand to see at least 5% cuts or more under certain proposals.
The 60-day comment period closed Sept. 12, with hundreds of organizations submitting objections. CMS will issue a final rule later this year.
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