When CMS released the 2026 Fee Schedule Final Rule in November, medical practices were surprised to see that it included not one conversion factor, but two.

Read on to discover how to determine which conversion factor will apply to you.

Most Practices Will See a Conversion Factor of $33.40

The majority of medical practices will be paid using the conversion factor of $33.40, which is up more than 3% from the 2025 value of $32.35. The 3.26% upgrade includes a one-time 2.5% increase that Congress approved as part of the One Big Beautiful Bill, along with a 0.49% budget neutrality adjustment related to what were described as misvalued codes, and another -2.5% efficiency adjustment.

This conversion factor applies to providers who don’t participate in a qualified alternative payment model (APM).

APM Participants Will See Higher Conversion Factor

Effective January 1, practices that participate in qualified alternative payment models will get paid under a slightly higher conversion factor of $33.57. This is up 3.77% from the 2025 conversion factor, providing APM participants with a slightly higher revenue rate than those who aren’t qualified participants (QPs) in the APM program.

What Are QPs?

 Providers who will collect the higher conversion factor rate participate in advanced APM programs, such as the Medicare Shared Savings Program or CMS Innovation Models. Many analysts believe the dual conversion factor decisions stems from Congress’ desire to incentivize practices to move away from fee-for-service payments and into more value-based care programs.

While conversion factors did rise for 2026, many physician advocacy organizations believed that the numbers should have been even higher to benefit practices, which have seen revenue drop in recent years.

“That physicians are not facing a reduction in reimbursements—as we have in the past—is a significant positive for 2026 and a win for patients’ access to care. Yet, this one-time correction does not keep up with increasing costs, and private practices across the country are expressing concern this rule would further put them at a disadvantage merely for treating patients at a hospital or ambulatory surgery center,” said AMA President Bobby Mukkamala, MD, in a statement.