The Medicare Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment System (HOPPS) / Ambulatory Surgery Center (ASC) final rules are typically released in early November to be effective for the following calendar year. However, with the federal government shutdown now entering its fifth week, there is the possibility the CY 2026 final rules could be delayed. Even if the rules are delayed, their effective date will still be Jan. 1, 2026. During the October 2013 federal government shutdown, which lasted 16 days, the Medicare PFS and HOPPS/ASC final rules were released on Nov. 27, 2013.
¶¶Òô´ó¹Ï members should prepare for final rules that could have a significant impact on CY2026 Medicare payments, including application of a new ‘efficiency adjustment’ that would result in a 2.5 percent reduction to PFS services, as well as reductions to physician practice expense payments under the PFS when services are delivered in the hospital or ASC. ¶¶Òô´ó¹Ï opposed both proposals in its
PFS and
HOPPS /ASC comment letters and urged that they not be finalized.