In Depth Analysis

Read key takeaways from the final rule and access our updated, interactive data dashboard.

On October 31, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) final rule, including a number of significant policy changes effective January 1, 2026 (unless otherwise noted). Among them, CMS finalized a major change to the practice expense (PE) methodology that halves the indirect PE allocated to facility-based services, reshaping payment relativity and shifting spend toward office-based care.

This +Insight examines the status of six key MA issues – prior authorization, risk adjustment, Star Ratings, supplemental benefits, provider directories, and marketing – and considers likely next steps for policymakers.

Explore our tracker of healthcare-related executive orders (EOs) issued by the Trump administration, including overviews of each EO and the date each EO was signed. We will regularly update this tracker as additional EOs are published.

Congress has previously extended the Medicare fee-for-service telehealth flexibilities that were originally implemented during the COVID-19 public health emergency in 2020 multiple times, with the latest extension expiring September 30, 2025. While there is broad bipartisan support for these flexibilities, Congress has included the short-term extensions in government funding legislation. Because Congress did not reach an agreement on government funding prior to the expiration of these flexibilities, as of October 1, 2025, the Medicare telehealth flexibilities revert to pre-pandemic limitations.