This week, ACG, AGA, and ASGE submitted joint recommendations in response to the Centers for Medicare & Medicaid Services’ (CMS) CY2026 Medicare Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Centers (ASC) proposed rules.

Our letters emphasized the urgency to improve practice issues and payment rates for gastroenterologists in 2026. We expect CMS to release the final Medicare rules later this fall.

The GI societies also met with CMS twice in August to convey concerns about proposals in these rules, including:

• Persistent reimbursement challenges within the PFS. We remain frustrated over the lack of reimbursement updates. Despite the first increase to the Medicare PFS conversion factor in five years (+2.5%), the temporary update still does not adequately account for increased practice costs.
• A universal –2.5% efficiency adjustment to work relative value units (RVUs) for non-time-based services, which is based on the faulty assumption that physicians continually become faster in delivering care. As we shared with CMS, this assumption is not grounded in empirical data – or data shared in the proposed rule – and is counter to the goals of increasing quality of care.
• Significant changes to practice expense (PE) methodology that threatens patient access to GI services and would significantly cut payments to physicians for services performed in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASC). CMS’ proposal ignores the reality of how GI providers deliver care, where employed and independent gastroenterologists maintain offices, staff, and billing infrastructure – even when performing procedures in hospitals or ASCs.

We urged CMS to collaborate directly with the physician community to develop evidence-based approaches that preserve patient access to high-quality care.

We need your voice — time is running out!

Your voice matters – contact CMS directly and sharing your practice-level data and how these policies will impact patient care. Get started using our advocacy tool.

The deadline for submitting comments is tomorrow, Friday September 12, at 11:59 p.m. ET

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Resources

For more information, read our final comment letters and summaries from July: