2026 Gastroenterology Reimbursement and Coding Update (Virtual) | November 2025-Changes to Reimbursement Landscape- HR1 and MPFS

Video Transcription

Video Summary

The speaker, a gastroenterologist, discusses significant upcoming changes to the 2026 Medicare Physician Fee Schedule affecting GI reimbursement. Despite a slight 3.26% conversion factor increase, new CMS policies impose a 2.5% efficiency adjustment cutting work RVUs and a 50% reduction in indirect practice expense payments for facility-based endoscopy. These changes create financial losses, especially for facility-based practices performing most GI procedures, resulting in an estimated 8% payment decrease and a $58 million nationwide cut. With rising operational costs and reimbursement cuts, GI practices must enhance billing, coding, and documentation expertise to adapt and maintain viability.

Asset Subtitle

Edward Sun, MD, MBA, FASGE

Meta Tag

Concept Medicare Physician Fee Schedule

Concept GI Practice Reimbursement

Concept Efficiency Adjustment

Concept Practice Expense Methodology

Concept Conversion Factor

Keywords

2026 Medicare Physician Fee Schedule

GI reimbursement changes

CMS efficiency adjustment

facility-based endoscopy cuts

gastroenterology billing and coding

Medicare Physician Fee Schedule

GI Practice Reimbursement

Efficiency Adjustment

Practice Expense Methodology

Conversion Factor