Medicare Finalizes 2026 Medicare Fee Schedule: Modest Updates but Continued Cuts

November 13, 2025

The Centers for Medicare & Medicaid Services (CMS) has released the 2026 Medicare Physician Fee Schedule (MPFS) final rule, effective January 1, 2026. The rule sets payment rates and policy updates for audiologists and speech-language pathologists (SLPs) who bill under Medicare Part B.

In addition, President Trump has signed into law a continuing resolution (CR) to reopen the government, which gives Medicare providers temporary relief on key issues such as telehealth authority and payment cuts. Specifically, the CR

• Extends Medicare telehealth authority for audiologists and SLPs through January 30, 2026;
• Restores the 1.0 geographic practice cost index (GPCI) floor through January 30, 2026, and;
• Eliminates the 4% statutory "Pay-As-You-Go" (PAYGO) cut through 2026.

Although the elimination of the 4% cut is a significant win, ASHA will continue to advocate to ensure that telehealth and other payment cuts are addressed at least through the end of the year.

Payment Outlook: Modest Gains, Potential Deep Reductions

Although Congress approved a one-time 2.5% payment increase for 2026 and the most recent CR provides additional payment relief as a result of extensive advocacy by ASHA and other stakeholders, all providers paid under the MPFS face continued downward pressure on reimbursement unless Congress intervenes again.

• Audiologists may see reductions of about 3%.
• SLPs could face cuts approaching 4%.

In addition, without additional legislative action to stabilize Medicare payment, all Medicare providers will experience declining reimbursement rates year after year.

CMS established two conversion factors (CFs) for 2026, as required by federal law:

• $33.57 for clinicians in qualified Advanced Alternative Payment Models (APMs)
• $33.40 for all others (applicable to most audiologists and SLPs)

These rates include the 2.5% increase approved by Congress for 2026.

Additional Payment Policy Changes

• Practice Expense (PE) Rebalancing: Beginning in 2026, CMS will increase non-facility PE values and reduce facility values. This change should benefit most audiologists and SLPs, since most services are paid at non-facility rates.
• Efficiency Adjustment: A 2.5% productivity reduction will apply to select non-time-based diagnostic and procedural codes. However, codes on the telehealth services list (such as CPT 92507 and 92557) are exempt from this reduction.
• Malpractice and Geographic Index Updates: New values take effect, with the 1.0 GPCI floor expiring after January 30, 2026, unless extended by Congress.

ASHA Action: ASHA continues to oppose payment cuts and will advocate for long-term Medicare payment stability and fair reimbursement for audiologists and SLPs.

Telehealth Coverage: Permanent Codes, Pending Authority

Advocacy win! Following sustained ASHA advocacy, CMS finalized permanent inclusion of select audiology and speech-language pathology CPT codes on the Medicare Telehealth Services List, ensuring continued access to care for patients who began receiving services remotely during the pandemic. However, Congress must extend or make permanent telehealth billing authority for both professions.

• New additions: Audiologists now have auditory osseointegrated device (AOD) codes on the telehealth services list.
• Provider privacy: Clinicians can suppress their home address when providing telehealth services from home.

ASHA Action: ASHA continues to urge Congress to make telehealth billing authority for audiologists and SLPs permanent.

Take action today: Send a message to your legislators supporting this effort.

Policies for SLPs

CMS will maintain the following policies in 2026:

• Multiple Procedure Payment Reduction (MPPR)
• Targeted Manual Medical Review

The KX modifier threshold remains at $2,480 for combined PT/SLP services, and the medical review threshold stays at $3,000.

Coding Updates

• Audiologists: 12 new hearing device services codes will replace longstanding hearing aid-related codes (not covered under Medicare).
• SLPs: Expanded Remote Therapeutic Monitoring (RTM) codes allow for shorter monitoring periods (2-15 days) and new treatment management codes now cover 10-19 minutes of clinician interaction.

Quality Programs

Most audiologists and SLPs remain exempt from reporting under the Merit-based Incentive Payment System (MIPS), though reporting remains available for those meeting eligibility criteria.

Key updates: CMS removed two Social Determinants of Health (SDOH) measures from quality reporting measure sets. However, each specialty continues to have a robust quality measure set available for reporting purposes to ensure flexibility and improve chances of successful MIPS participation.

ASHA Advocacy and Next Steps

ASHA continues to advocate for:

• Congressional action to address deep 2026 Medicare cuts
• Permanent telehealth billing authority for audiologists and SLPs
• Long-term Medicare payment reform to ensure fair and stable reimbursement.

Clinicians are encouraged to contact their members of Congress to urge them to expand Medicare telehealth access and address Medicare Part B payment cuts.

Resources and Contact

Within the next few days, ASHA will release a detailed analysis of the MPFS-including payment tables-on our Medicare Payment for Outpatient Audiology and Speech-Language Pathology Services webpage.

Questions?

Contact [email protected].