Miriam Gonzalez Consulting
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Welcome to Miriam Gonzalez Consulting Services

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Updates and Resources

Physician Fee Schedule 2025

Physician Fee Schedule 2025

Physician Fee Schedule 2025

https://www.cms.gov/medicare/physician-fee-schedule/search

Physician Fee Schedule 2026

Physician Fee Schedule 2025

Physician Fee Schedule 2025

 The CMS 2026 Physician Fee Schedule (PFS) final rule was released on October 31, 2025, and includes policy changes effective January 1, 2026. Key updates include the implementation of two separate conversion factors—one for qualifying Alternative Payment Model (APM) participants ($33.57) and one for non-qualifying participants ($33.40)—representing approximately 3-4% increases from 2025. The rule also introduces an efficiency adjustment of -2.5% for certain non-time-based services, makes the removal of frequency limits for subsequent inpatient/nursing facility/critical care visits permanent, and finalizes a permanent virtual supervision policy for services like diagnostic and rehabilitation. 

  • Calendar Year (CY) 2026 Medicare Physician Fee Schedule ...Oct 30, 2025 — Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F) Administration. Calendar Year (CY) 202...Centers for Medicare & Medicaid Services | CMS (.gov)
  • CMS issues CY 2026 physician fee schedule final ruleOct 30, 2025 — The Centers for Medicare & Medicaid Services Oct. 31 released its calendar year 2026 final rule for the physician fee ...American Hospital Association
  • Dive Into the 2026 Medicare Physician Fee Schedule Final RuleNov 5, 2025 — The Centers for Medicare and Medicaid Services (CMS) has released the 2026 Medicare Physician Fee Schedule (PFS) final ...American College of Cardiology

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https://www.cms.gov/medicare/physician-fee-schedule/search

Medicare NCCI Edits

Physician Fee Schedule 2025

CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)

https://www.cms.gov/medicare/coding-billing/ncci-medicare

CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)

CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)

CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)

https://www.cms.gov/priorities/burden-reduction/overview/interoperability/policies-and-regulations/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f

Healthcare Common Procedure Coding System (HCPCS)

CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)

Healthcare Common Procedure Coding System (HCPCS)

https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system

Web MD

CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F)

Healthcare Common Procedure Coding System (HCPCS)

https://www.webmd.com/

Coding Guidelines

Coding Guidelines

Coding Guidelines

https://www.cms.gov/files/document/fy-2025-icd-10-cm-coding-guidelines.pdf

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