Anders Gilberg MGMA prospectives on the 2026 physician fee schedule

The Medical Group Management Association (MGMA) is raising alarms over elements of the proposed 2026 Medicare Physician Fee Schedule, published by the Centers for Medicare & Medicaid Services (CMS) in July, that could shift how relative value units (RVUs) are determined—potentially sidelining physician input in the process.

"This type of document is 2,000 pages long and it's full of policies. It also sets the rates for the following year, but it often does so outside of what we usually talk about, like the conversion factor and the Medicare cuts, with relative value units (RVUs), where you have work RVUs, practice expense RVUs to deal with overhead costs, and malpractice RVUs,” explained Anders Gilberg, MGA, senior vice president, government affairs at the MGMA, in an interview with HealthExec.

According to Gilberg, CMS is proposing adjustments to work RVUs and practice expense RVUs that could redistribute funding from procedural and diagnostic specialties—such as cardiology and radiology—toward more time-based primary care specialties. While MGMA supports addressing the financial challenges facing primary care, the association is concerned about how these changes were developed.