Qualifying Alternative Payment Model for eligible participants Medicare Physician Fee Schedules for 2026

If you have elected to be a participant during 2026, the limiting charges indicated on the report will not pertain to your practice. The non-participating fee schedule amounts and limiting charges do not apply to services or supplies unless they are paid under the physician fee schedule. Limiting charge applies to unassigned claims by non-participating providers. All services provided to Medicare beneficiaries are subject to audit and documentation requirements.

 

April 2026 Update

The 2026 MPFS has been updated to include the following procedure codes: Q4418, Q4419, Q4421, Q4122, Q4123, Q4424, Q4425, Q4426, Q4427, Q4428, Q4429, Q4435, Q4436, Q4437, Q4438, Q4439, and Q4440. The fees are effective April 1, 2026 through December 31, 2026. (CMS Change Request 14392)

Northern California

Southern California

January 2026 Update

The 2026 MPFS has been updated with revised fees for the following procedure codes: 21610, 22319, 22554, 26562, 33269, 33464, 33983, 35221, 37215, 37660, 44322, 58290, 60271, 61320, and 64804. The fees are effective January 1, 2026 through December 31, 2026. (CMS Change Request 14392)

CMS has established the CY 2026 Qualifying Alternative Payment Model (APM) for eligible participants (QPs). The fee schedules are listed below and are effective January 1, 2026 through December 31, 2026. (CMS Change Request 14234)

Northern California

Southern California

 

Last Updated Mar 06 , 2026