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Sources & disclaimer

Rates reflect the CY 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F), published in the Federal Register on November 5, 2025 and effective January 1, 2026. Amounts shown are the National Payment Amount, Non-Facility Price, retrieved from the CMS Physician Fee Schedule Look-Up Tool.

CY 2026 RTM reimbursement — national average

Citation

• Primary source (rule): Centers for Medicare & Medicaid Services. Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program. 90 FR 49266. November 5, 2025. federalregister.gov/d/2025-19787
• Payment amounts (CMS Physician Fee Schedule Look-Up Tool): cms.gov/medicare/physician-fee-schedule/search
• CMS Fact Sheet: CY 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F)

Disclaimer

Rates shown are national average Medicare payment amounts (non-facility) for informational purposes only. Actual reimbursement varies by geographic locality due to the Geographic Practice Cost Index (GPCI), which adjusts payments based on regional differences in physician work, practice expense, and malpractice costs. Most localities fall within roughly 10% of the national average, though high-cost areas (such as Alaska, Manhattan, and San Francisco) and rural localities may differ more significantly. Reimbursement also varies based on APM participation status, commercial payer contracts, Medicare Advantage plans, state Medicaid policies, and Medicare Administrative Contractor (MAC) determinations. Facility-setting payment amounts differ from the non-facility amounts shown. For locality-specific or facility-setting rates, use the CMS Physician Fee Schedule Look-Up Tool. VitaTrax does not provide billing, coding, or legal advice; providers are responsible for ensuring compliance with all applicable Medicare guidelines and payer requirements.