The Centers for Medicare & Medicaid Services (CMS) has issued a proposed Medicare Physician Fee Schedule (MPFS) rule for 2026, which would impact imaging services.
The proposed rule aims to cut spending waste, as well as improve quality measures and chronic disease management for people with Medicare. This will affect the fields of radiology, nuclear medicine, and radiation oncology, experts say.
"This move reflects our continued shift toward smarter, data-informed policymaking," Deputy Administrator and Director of the Center for Medicare Chris Klomp said in a CMS statement. "We’re advancing technical improvements that reward high-quality, efficient care; addressing the root causes of unique health challenges; and aligning healthcare spending with value so that new innovations help to deliver better quality at a lower price."
Beginning on January 1, 2026, under the proposed rule, there will be two separate conversion factors for qualifying and nonqualifying alternative payment model (APM) participants. These stem from the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
The proposed update to the qualifying APM conversion factor for 2026 is $33.58 with a 0.75% annual update, while the update to the nonqualifying APM conversion factor is $33.42 with a 0.25% annual update.
Both conversion factors also include a 2.5% one-year increase to the MPFS conversion factor included in the recent budget reconciliation law (the One Big Beautiful Bill) and a proposed 0.55% budget neutrality adjustment.
The American College of Radiology (ACR) in a statement noted that the CMS estimates an overall impact of the proposed MPFS changes to be the following: -2% for radiology, -1% for nuclear medicine, 2% for interventional radiology, and -1% for radiation oncology.
The ACR developed an initial summary of how the new rule will impact radiology. The summary contains information on six new Merit-based Incentive Payment System (MIPS) Value Pathways (MVPS) that may become available for reporting in 2026 if finalized. These include diagnostic radiology, interventional radiology, neuropsychology, pathology, podiatry, and vascular surgery MVPs.
CMS has organized the diagnostic radiology MVP into three clinical groups: General diagnostic radiology, body imaging (thoracic/abdominal), and advancing health and wellness. And the proposed interventional radiology MVP has been arranged into four clinical groups: Vascular, dialysis-related, neurological intervention, and general interventional radiology.
“Depending on the clinical groups in both MVPs, CMS has assigned measures and activities it considers attributable to these radiologists,” the ACR’s initial summary states.
This story will continue to be updated.
