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Physicians

Medicare Payments for Doctors Could See a 3.8% Increase in 2026

Strategic Insights

— 1 min read

The Trump administration has released a proposal that could lead to a 3.8% increase in Medicare payments for doctors in 2026. This is a significant change from the previous trend of declining payment rates for physicians. The increase would be a result of a provision in the Medicare Access and CHIP Reauthorization Act (MACRA) that was passed in 2015, which aims to encourage the adoption of value-based care models.

Key Takeaways:

  • Physicians who participate in alternative payment models that focus on patient outcomes are eligible for a 3.8% pay bump in 2026.
  • Doctors who do not participate in a qualifying alternative payment model would receive a 3.3% increase.
  • The proposed rule would adjust payment for billing codes using a figure calculated by Medicare actuaries, which would decrease payment for codes that aren't based on physicians' time by 2.5% in 2026.
  • The change would likely lead to increased pay for specialties like family medicine, geriatrics, and psychiatry, which often bill for timed codes.
  • Specialties that bill for procedures, such as radiation oncology and radiology, would likely see decreased payment for their codes.

Statistics:

  • 3.8% increase in Medicare payments for doctors participating in alternative payment models in 2026.
  • 3.3% increase in Medicare payments for doctors not participating in alternative payment models in 2026.
  • 2.5% decrease in payment for billing codes that aren't based on physicians' time in 2026.
  • 1,803 pages in the administration's proposal outlining changes to Medicare payment.

Sources:

  • Axios, "Doctors could see up to a 3.8% increase in Medicare payments next year under a Trump administration proposal released Monday." (https://www.axios.com/2024/07/11/doctors-medicare-payment-cut-2025)
  • Axios, "Congress just passed a massive tax and spending bill with a provision that could help doctors get paid based on patient outcomes." (https://www.axios.com/2025/07/07/medicaid-impacts-tax-bill-delayed)
  • Centers for Medicare and Medicaid Services, "Proposed Rule: Medicare Program; Revisions to Payment Policies and Adjustments Under the Physician Fee Schedule for Chronic Drug Infusions." (fact sheet cited)

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