Major Increase in Medicare Doctor Payment Stability Threshold.
This law aims to stabilize payments for doctors who treat Medicare patients by significantly raising the threshold used to calculate mandatory fee adjustments. Starting in 2026, this limit will increase from $20 million to $53 million, making it less likely that small changes in medical service costs will trigger large, mandatory cuts or increases across all physician services. This change is intended to help ensure that seniors continue to have reliable access to doctors who accept Medicare.
Key points
Increases the limit for Medicare payment adjustments (budget neutrality threshold) from $20 million to $53 million starting in 2026.
The higher limit provides greater stability in Medicare payments to doctors, potentially improving access to care for beneficiaries.
Starting in 2031, the threshold will be automatically adjusted every five years based on inflation in medical costs.
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