Federal Rule That Sets Medicare Part B Rates Finalized

(Nov. 18, 2025) The Centers for Medicare and Medicaid Services (CMS) finalized the Physician Payment Rule that sets Medicare Part B rates for calendar year 2026 and updates other Part B payment and coverage policies. These are rates for services delivered in settings including nursing homes and other post-acute care settings, hospices, as well as physicians’ offices and hospitals. Overall, there is an increase of about 3.25% to the conversion factor (a bit higher for physicians who participate in alternative payment models). In addition, there are changes to the place of service rules that will affect nursing home payments, as well as a number of policy changes that impact Medicare telehealth services, skin substitute reimbursement, chronic conditions management, and other issues that are described in detail in an article from LeadingAge National that members can access here. The CMS Final Rule fact sheet is available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841