Quality Payment Program Claim Adjustment Applied to Correct Conversion Factor

The Centers for Medicare & Medicaid Services has found a system issue related to the 2026 Medicare Physician Fee Schedule conversion factors.

Medicare Administrative Contractors will receive an automatic adjustment for affected claims processed between Jan. 1 and Feb. 26, 2026. The correct conversion factor updates include a 0.75 percent conversion factor increase for qualifying Alternative Payment Model (APM) participants and a 0.25 percent increase for nonqualifying APM participants.

Most corrections are projected to be completed by early May.

Source:

https://med.noridianmedicare.com/web/jeb/article-detail/-/view/10525/claim-adjustments-to-correct-conversion-factor-for-quality-payment-program-qpp-claims

https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f