Navigating the 2026 MPFS Final Rule: Impact on Gastroenterology and Your Bottom Line

Video Transcription

Video Summary

The ASGE live stream event "Navigating the 2026 Medicare Physician Fee Schedule Final Rule: Impact on Gastroenterology and Your Bottom Line" provided a comprehensive discussion on the impending changes to Medicare reimbursement affecting GI practices. Moderated by Drs. Glenn Littenberg and Ed Sun, and featuring expert panelists including ASGE President Dr. Amitabh Chak and leaders from private practice, academic, and health system settings, the session addressed key changes and practical strategies.<br /><br />Critical updates include a modest 3.26% increase in the Medicare conversion factor for 2026, offset by a 2.5% efficiency adjustment cutting work RVUs for non-time-based codes, primarily endoscopic procedures, and a controversial 50% cut to indirect practice expense allocation for facility-based services. Collectively, these changes are projected to cause an 8% reduction in physician payments for endoscopy, disproportionately impacting procedures performed in hospital outpatient departments or ambulatory surgery centers (ASCs).<br /><br />Panelists emphasized operational adaptations such as consolidations, diversification into ancillary services (e.g., anesthesia, pathology, weight management), and exploring office-based endoscopy where feasible. They highlighted the regulatory and capital barriers, particularly in certificate-of-need (CON) states, and encouraged leveraging AI technologies for efficiency gains in scheduling, intake, and revenue cycle management.<br /><br />Physicians were urged to demand transparency in coding and billing, collaborate with practice managers on data analytics, and actively engage in advocacy efforts with ASGE and policymakers. Contract negotiations should aim to decouple from fluctuating Medicare schedules, focusing on stable, predictable rates.<br /><br />The consensus was clear: while the policy changes pose significant challenges, they also present opportunities for gastroenterologists to innovate, optimize operations, and redefine practice models—all serving the paramount goal of providing high-quality patient care.

Keywords

Medicare Physician Fee Schedule 2026

Gastroenterology reimbursement

Medicare conversion factor increase

Efficiency adjustment work RVUs

Indirect practice expense cuts

Endoscopy payment reduction

Hospital outpatient department impact

Ambulatory surgery centers

Office-based endoscopy

Ancillary services diversification

AI in healthcare operations

Healthcare policy advocacy