{"id":449073,"date":"2025-11-12T09:14:41","date_gmt":"2025-11-12T14:14:41","guid":{"rendered":"https:\/\/www.billingparadise.com\/blog\/?p=449073"},"modified":"2026-06-04T04:20:57","modified_gmt":"2026-06-04T09:20:57","slug":"medicare-physician-fee-schedule-for-podiatry","status":"publish","type":"post","link":"https:\/\/www.billingparadise.com\/blog\/medicare-physician-fee-schedule-for-podiatry\/","title":{"rendered":"How the New Medicare Fee Schedule Reshapes Podiatry in 2026"},"content":{"rendered":"
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<\/a><\/a><\/a><\/a><\/a>Share on your feed<\/a><\/div><\/div>\n<\/div><\/div>

Table of contents<\/b><\/h2>\n<\/div><\/div>

What Does 2026 Medicare Physician Fee Schedule Proposed Rule Mean for Podiatry?<\/a><\/p>\n<\/div><\/div>

Understanding the 2026 Medicare Physician Fee Schedule Proposed Rule
\n<\/a><\/p>\n<\/div><\/div>

Key Provisions & Changes Relevant to Podiatry
\n<\/a><\/p>\n<\/div><\/div>

Who Will Be Impacted and How
\n<\/a><\/p>\n<\/div><\/div>

How the 2026 PFS Will Impact Your Podiatry Practice
\n<\/a><\/p>\n<\/div><\/div>

Steps to Prepare Your Practice \/ RCM Team
\n<\/a><\/p>\n<\/div><\/div>

How RCM Services Can Help Your Podiatry Practice
\n<\/a><\/p>\n<\/div><\/div>

Final Thoughts & Looking Ahead
\n<\/a><\/p>\n<\/div><\/div><\/div><\/div><\/section><\/div>

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What Does 2026 Medicare Physician Fee Schedule Proposed Rule Mean for Podiatry?<\/b><\/h2>\n<\/div><\/div>[vc_empty_space]

Have you ever imagined an increase in Medicare reimbursements could transform the <\/span>financial management strategy<\/span><\/a> of your podiatry practice? The 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule that has a direct impact on Medicare payments of thousands of physicians and clinicians.<\/span><\/p>\n

Let’s take a detailed outlook at the fee schedule proposed rule. This article explores what\u2019s new, what\u2019s risky, how payment methodologies are shifting, and practical strategies for podiatry.\u00a0<\/span><\/p>\n

Improving Quality of Care Using CMS Medicare Physician Fee Schedule (PFS)<\/b><\/h3>\n

In July 2025, the Centers for Medicare & Medicaid Services (CMS) released the 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule, aiming to improve the quality of care for Medicare beneficiaries and cut down unnecessary Medicare spending.\u00a0<\/span><\/p>\n

This rule is proposed as a part of a broader movement to streamline Medicare payments, with unwavering attention to quality, efficiency, and innovation. By being duly aware of the rule can help you reduce denials, maximize reimbursements, and position your podiatry practice for long-term success.\u200b<\/span><\/p>\n

What is the CMS Physician Fee Schedule (PFS) Proposed Rule?<\/b><\/h3>\n

The 2026 CMS Physician Fee Schedule proposed rule is a draft that proposes changes on how Medicare should pay physicians for the calendar year 2026 (CY26). It includes key changes on revised payment conversion factor, efficiency adjustments for work Relative Value Units (RVUs), practice expense calculation, and Telehealth Services List addition.\u00a0<\/span><\/p>\n

This rule will be released every year with proposed policies and payment rates for public comment before finalizing them.<\/span><\/p>\n<\/div><\/div>

Why must podiatry practices pay attention to the CMS PFS?<\/b><\/h3>\n


\n<\/b>Many podiatry practices are now obliged to adapt to the latest CMS changes, with the increase in RVUs for critical procedures, the introduction of specialty-focused MIPS Value Pathways, and intensifying compliance demands involving telehealth, remote monitoring, and chronic condition management.\u200b<\/span><\/p>\n

This matters now because the 2026 Medicare PFS goes into effect on January 1st, 2026, directly impacting how your services are reimbursed, patients are managed, and revenue is protected amid tightening margins and regulatory scrutiny. Keeping up with code changes, billing risk exposure, and quality reporting requirements can make or break your results\u2014and leave your team scrambling if you\u2019re unprepared.\u00a0<\/span><\/p>\n

As you navigate a healthcare environment shaped by new regulations and rapidly changing medicare reimbursement structures, the release of the 2026 Medicare Fee Schedule (PFS) is more than just another yearly update\u2014it\u2019s a pivotal moment for your practice\u2019s bottom line and strategic planning.\u00a0<\/span><\/p>\n

Let\u2019s dive into what every forward-thinking podiatry practice leader should know about the 2026 Medicare PFS.<\/span><\/p>\n<\/div><\/div>[vc_single_image image=”449079″ img_size=”full”][vc_empty_space]

Understanding the 2026 Medicare Physician Fee ScheduleProposed Rule<\/b><\/h2>\n<\/div><\/div>[vc_empty_space]

CMS rolled out the proposed Medicare Physician Fee Schedule (PFS) for 2026 on July 14, 2025. This update covers just about everything that affects outpatient services under Medicare Part B\u2014think payment rates, telehealth, reporting, and what counts as a practice expense. Podiatrists are in the mix, too. Right now, the rule\u2019s open for public comments until September 12, 2025. This window gives your practice, industry groups, and <\/span>RCM partners<\/span><\/a> a shot at speaking up and pushing for changes before anything becomes official on January 1, 2026.<\/span><\/p>\n

Conversion Factor Updates: Separate Rates for APM Participation<\/b><\/h3>\n

This time, CMS wants to bump up the conversion factor. Podiatrists on the standard track will get a 3.62% increase, bringing the rate to $33.42. But if you\u2019re in an approved Advanced Alternative Payment Model (APM), you\u2019ll see a slightly higher jump, 3.83%, or $33.59 per RVU. These updates stand apart from the usual budget tweaks and highlight recent advocacy efforts, including that 2.5% temporary increase for all doctors from the \u201cOne Big Beautiful Bill\u201d Act.<\/span><\/p>\n

Practice Expense and Efficiency Adjustments<\/b><\/h3>\n

CMS isn\u2019t stopping at payment rates. They\u2019re also fine-tuning how they calculate practice expenses. One thing to watch: a new \u201cefficiency adjustment\u201d could mean lower payments for services performed in hospital or facility settings compared to office-based care.\u00a0<\/span><\/p>\n

The idea is to reflect real-world cost differences and drive better efficiency. If you\u2019re moving more procedures to outpatient or ASC settings, keep an eye on this – these reimbursement adjustments could affect your <\/span>payment reconciliation <\/span><\/a>processes and impact your bottom line.<\/span><\/p>\n<\/div><\/div>[vc_raw_html]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[\/vc_raw_html]

General Policy Changes in 2026 Under PFS\u00a0<\/b><\/h3>\n

Telehealth and Remote Care:\u00a0<\/b><\/h4>\n

CMS plans to keep expanding telehealth, more flexibility for remote supervision, chronic care management, and some remote patient monitoring codes. There\u2019s real momentum here, but final approval for some of these changes will come down to what Congress decides after September.<\/span><\/p>\n

Site-of-Service Changes:<\/b><\/h4>\n

Payments will start to vary more depending on where care happens. If you\u2019re running a podiatry group, you\u2019ll want to take a hard look at whether you keep services in-office or partner up with hospitals.<\/span><\/p>\n

New Practice Models: <\/b><\/h4>\n

There\u2019s a new MIPS Value Pathway (MVP) on the table just for podiatry. This gives you more ways to report quality and get in sync with value-based payments.<\/span><\/p>\n

When you add it all up, rate increases, more options for reporting, and new models for care, the 2026 PFS stands out as one of the biggest regulatory updates for podiatry in years. Now\u2019s the time to get ready before the final rule drops at the end of 2025.<\/span><\/p>\n<\/div><\/div>[vc_empty_space]

Key Provisions & Changes Relevant to Podiatry<\/b><\/h2>\n<\/div><\/div>[vc_empty_space]

Get ready\u20142026 is shaping up to be a big year for podiatry practices under Medicare. Let\u2019s break down what\u2019s new, what\u2019s changing, and what you need to keep an eye on.<\/span><\/p>\n

Conversion Factor and RVU Changes for Foot\/Ankle Services<\/b><\/h3>\n

Podiatrists can expect a payment bump of over 4% next year, thanks to a mix of CMS\u2019s proposed conversion factor increases (3.62% for most, 3.83% for qualifying APM participants) and a one-time 2.5% boost from Congress.\u00a0<\/span><\/p>\n

That\u2019s not all, CMS wants to raise Work RVUs for some of the most common foot and ankle surgeries. For example, CPT code 28750 (ankle arthrodesis) jumps from 8.57 to 8.75 RVUs, and 28755 (hindfoot arthrodesis) shoots up from 4.88 to 6.76 RVUs. These aren\u2019t small changes, they\u2019ll make a real difference in Medicare reimbursements for specialized foot and ankle surgeries.<\/span><\/p>\n

Practice Expense Calculations Are Shifting<\/b><\/h3>\n

CMS is tweaking how it figures out practice expenses for 2026. There\u2019s a new \u201cefficiency adjustment\u201d coming, which could lower payments for services done in hospitals or facilities.\u00a0<\/span><\/p>\n

On the flip side, office-based procedures might see better reimbursement. For podiatry practices, this means you\u2019ll need to pay close attention to where you provide services and how that affects your bottom line.<\/span><\/p>\n

Telehealth, Supervision, and Remote Services Are Expanding<\/b><\/h3>\n

Telehealth options keep growing. More podiatry chronic care management, remote monitoring, and outpatient services could be delivered via telehealth, pending Congress\u2019s approval.\u00a0<\/span><\/p>\n

CMS also wants to loosen up supervision requirements and keep some of the remote service changes that started during the public health emergency. Flexibility is definitely on the rise.<\/span><\/p>\n

A New Value-Based Reporting Track for Podiatry<\/b><\/h3>\n

A dedicated MIPS Value Pathway (MVP) for podiatry is coming in 2026. This gives practices a fresh way to report quality and track value-based performance.\u00a0<\/span><\/p>\n

It\u2019s smart to review whether the new MVP or the old-school MIPS system fits your practice better, especially if you\u2019re rethinking your approach to quality and revenue.<\/span><\/p>\n

Coverage and Coding – Don\u2019t Skip the Details<\/b><\/h3>\n

Every podiatry practice needs to dig into the specialty-specific CPT codes for 2026. Updates to coverage, coding, and RVUs affect more than just Medicare reimbursements; they\u2019ll impact the <\/span>podiatry medical billing <\/span><\/a>workflows, documentation standards, and compliance. You can\u2019t afford to ignore these changes.<\/span><\/p>\n<\/div><\/div>[vc_empty_space]

Who Will Be Impacted and How
\n<\/b><\/h2>\n<\/div><\/div>[vc_empty_space]