Medicare Payment Rates Proposed to Increase 2.4% for 2026
A proposed rule released by the Centers for Medicare and Medicaid Services (CMS) outlines a 2.4% increase to Hospital Outpatient Prospective Payment System (OPPS) rates for calendar year 2026. The changes, published in the July 17, 2025, Federal Register, impact a broad spectrum of healthcare providers beyond physicians, including physical and occupational therapists, speech-language pathologists, nurse practitioners, and physician assistants.
Impact on Medicare Providers
The proposed rule details new payment rates and policies affecting Medicare providers. This update is particularly significant as it extends beyond traditional physician services to encompass a wider range of clinicians crucial to patient care. The increase aims to reflect changes in the healthcare market and ensure adequate reimbursement for services rendered.
Breakdown of the Rate Increase
The 2.4% increase in OPPS payment rates is the result of a 3.2% market basket update, partially offset by a 0.8 percentage point productivity adjustment. This adjustment accounts for improvements in efficiency and output within the healthcare sector. The CMS aims to balance the need to keep pace with rising costs with the imperative to promote responsible spending.
Rehabilitation Providers to Receive Focused Analysis
The Rehabilitation and Community Providers Association (RCPA) will conduct a detailed analysis of the proposed rule, specifically focusing on its implications for rehabilitation providers. RCPA intends to provide members with a comprehensive understanding of how these changes will affect their practices and revenue streams. An OPPS fact sheet is available for additional information.
Call for Public Comment
The CMS is soliciting feedback on the proposed rule, with comments due by September 15, 2025. RCPA is encouraging its members to submit their comments and concerns to Melissa Dehoff by September 8, 2025, to be included in the organization’s official response. This collaborative approach ensures that the voices of rehabilitation providers are heard during the rulemaking process.
The proposed changes represent a significant development in Medicare payment policy, and ongoing analysis will be crucial for providers to navigate the evolving healthcare landscape.
