2026 Medicare Physician Fee Schedule Proposed Rule

Event Materials (Key Required)

Course Description

“2026 Medicare MPFS Trail Guide: Wrangling the New Rules”

Every year, Medicare reshapes the financial landscape for providers, and the 2026 Medicare Physician Fee Schedule (MPFS) is no exception. In this fast-paced, one-hour seminar, nationally recognized consultant. Don Self will walk attendees through the most important changes in plain English—using clear visuals, cowboy wit, and real-world examples that translate dense regulations into practical action steps.

We’ll start by breaking down the two new conversion factors (one for QPs and one for non-QPs) and explain why the much-talked-about -2.5% efficiency adjustment is more than just a line in the Federal Register—it’s a squeeze on providers that shifts dollars away from procedures and toward time-based care management. Attendees will see exactly what this means through side-by-side comparisons and case studies.

From there, we’ll explore the RPM and RTM code overhauls: new short-duration device supply codes, first 10-minute management options, and the valuation changes that could affect monthly recurring revenue streams. We’ll also cover the integration of APCM, BHI, and CoCM with new G-codes designed to reduce minute-counting burdens, as well as telehealth and supervision policies that directly impact rural health clinics and FQHCs.

Finally, participants will leave with clear action steps: how to audit their most-used codes, anticipate revenue impacts, educate staff, and prepare thoughtful ideas to be ready for the 2026 Changes.

Whether you’re a physician, NP, manager, or biller, this seminar arms you with the knowledge you need to keep your clinic compliant, profitable, and ready for January 1st.

Learning Objectives

• Identify the two conversion factors for 2026 and explain how QP and non-QP status affects reimbursement
• Describe the purpose and scope of the new -2.5% efficiency adjustment, including which services are impacted and which are exempt
• Compare the 2025 and 2026 RPM coding families, including the addition of short-duration device supply codes and first 10-minute management codes
• Differentiate between RPM and RTM coding structures for 2026, noting the unique device and management code options in each
• Explain how the new APCM add-on G-codes integrate Behavioral Health Integration (BHI) and Collaborative Care Management (CoCM) without minute-counting
• Summarize the 2026 telehealth policy changes, including additions to the Medicare telehealth list, the distinction between RPM/RTM and telehealth, and teaching physician presence requirements
• Evaluate how CMS’s decision to rely on OPPS cost data vs. survey data will impact practice expense calculations

Areas Covered in the Session

• Overview of the 2026 Medicare Physician Fee Schedule (MPFS) – why the updates matter and how they affect providers nationwide
• Conversion Factors Explained – breakdown of the two separate CFs for Qualified Participants (QPs) vs. non-QPs, and what this means for payment rates
• The New -2.5% Efficiency Adjustment – which services are impacted, which are exempt (E/M, CCM, APCM, BHI, maternity globals, telehealth), and how this shifts revenue
• Remote Physiologic Monitoring (RPM) Updates – new short-duration device supply code, revised management structure (first 10 minutes), and RVU decisions
• Remote Therapeutic Monitoring (RTM) Expansion – new device codes, additional management code, and CMS’s decision to hold RVUs lower than RUC recommendations
• APCM Integration with Behavioral Health – new G-codes (GPCM1–3) that allow bundling of APCM, BHI, and CoCM services without minute-counting
• Telehealth Policy Updates – additions and deletions to the Medicare telehealth list, clarification that RPM/RTM are not telehealth, and return to pre-PHE teaching physician presence rules
• Rural Health Clinic (RHC) and FQHC Updates – APCM add-ons recognized, G0071 remote evaluations, direct supervision via audio-video, and G2025 telehealth billing extended through 2026
• Practice Expense Valuation Changes – CMS’s rejection of AMA survey data, reliance on OPPS cost reports, and impacts on radiation therapy, monitoring, and skin substitutes
• Other Key Highlights – ASP clarifications (bundled arrangements, bona fide service fees), cell/gene therapy policy updates, and MIPS/QPP quality measure changes
• Live Q&A Session

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Suggested Attendees

• Medical Providers (Physicians, NPs, PAs)
• Office Managers and Administrators
• Medical Billers
• Coders
• Office Managers
• Practice Administrators
• Hospital Administrators
• Group Practice Executives
• Medical Billers
• Billing Staff
• Coders
• Coding Staff
• Denial Management Teams
• Revenue Cycle Specialists
• Auditors
• Compliance Officers
• Reimbursement Consultants
• Practice Management Consultants
• Quality Program Managers (QPP/MIPS)
• Telehealth Program Managers
• Behavioral Health Program Managers
• Rural Health Clinic (RHC) Leaders
• Federally Qualified Health Center (FQHC) Leaders
• Insurance Payers
• Insurance Company Claims Reviewers
• Payment Policymakers
• Healthcare Attorneys
• Policy Analysts
• Healthcare Accountants
• Chief Financial Officers (CFOs)
• Chief Operating Officers (COOs)
• Health System Executives
• Medical Association Leaders
• Third-Party Billing Companies

About the Presenter

Don Self, CPC, CMCS, CASA, is the CEO and founder of Don Self & Associates, a consulting firm specializing in medical reimbursements and helping physician practices improve patient outcomes and increase profits while staying compliant with all regulations. Don is also the President of Telecare-USA. Don has taught more than 900 seminars/ webinars over the past 38 years to tens of thousands of physicians, NPPs, coders and billers on coding, revenue, reimbursement and billing and 49 webinars in 2020 on Telehealth Billing. He has helped thousands make sure they are paid properly by Medicare and other payers.

Additional Information

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

• Internet Speed: Preferably above 1 MBPS
• Headset: Any decent headset and microphone which can be used to talk and hear clearly

Live Course Cancellation Policy: If for any reason Skillacquire need to cancel this program, Skillacquire will notify participants by email of the cancellation no less than 24 hours prior to the expected start time.

Can’t Listen Live? No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience.

For more information, you can reach out to the below contact:

Toll-Free No: 1-302-444-0162

Email: care@skillacquire.com 

This is a Live Virtual session.

A new way of immersive learning that allows you to engage live with our instructor and peers providing you with the flexibility to juggle the new work-life balance.

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