MDMax Diamond, M.D.HOSPITAL MEDICINE · HEALTHCARE QUALITY
POLICY DESK / REIMBURSEMENT

Medicare payment policy

National payment updates are a starting point. Specific reimbursement depends on the service, setting, location, documentation, and applicable adjustments.

REVIEWED SEPTEMBER 23, 2026

CY 2026 / PHYSICIAN

Two conversion factors

$33.57 / $33.40

Qualifying APM and nonqualifying clinicians, respectively. These are national conversion factors, not payment for an individual claim.

CMS final-rule summary ↗
FY 2027 / HOSPICE

Payment-rate update

+2.3%

CMS also finalized a $36,174.75 aggregate cap and changes to election-statement transparency.

CMS final-rule summary ↗
FY 2027 / SKILLED NURSING

SNF PPS update

+2.4%

National update; facility-specific Value-Based Purchasing adjustments are separate.

CMS final-rule summary ↗

Before using a rate

Confirm the effective year and date of service, relevant codes, locality, place of service, and any quality or contractual adjustment. Use official CMS payment files and your Medicare Administrative Contractor for claim-specific questions.