Hello partners,

We are excited to share that last Friday CMS released its Medicare Physician Fee Schedule (MPFS) CY 2026 final rule, which puts in place important policy priorities that our collective organizations have been fighting for for many years, including through our Consumers First coalition and most recently through its MPFS CY 2026 sign on comment letter.

CMS is taking critical first steps to rooting out a major conflict of interest in our health care payment system, ensuring our nation's families have access to the high-quality primary care and the robust primary care workforce that they need to live their healthiest lives. For the first time, CMS will be moving away from its heavy reliance on the American Medical Association's Relative Value Update Committee (RUC) and RUC survey data to set and update physician payment rates, which historically overvalues specialty and procedure-based services at the expense of high-quality primary care. Ultimately, these changes will help us move us closer to a health care system, whose fundamental economic incentives are oriented toward delivery of high value and equitable care that meets our nation's families' deepest needs.

None of this could have been done without your support. We appreciate and thank you for your partnership.

A few major wins in the CY 2026 rule include:

Updating the physician payment rate setting methodology to reflect changes in the health care system and gains in efficiency in the delivery of many professional services that will result in higher payments for primary care services.
Reducing the reliance on American Medical Association survey data when setting physician payment rates.
Expanding the scope of the Advanced Primary Care Management (APCM) service codes to include collaborative behavioral health and psychiatric care.
Introducing a new alternative payment model, Ambulatory Specialty Model (ASM), focused on improving cost and quality outcomes for patients experiencing heart failure and low back pain.

Thank you, and please reach out if you have any questions.

Mike Persley

Strategic Partnerships Campaign Manager

Families USA