Last night, the Centers for Medicare and Medicaid and Services (CMS) released the 2026 Medicare DMEPOS Fee Schedule. In 2026, the CPI-U of 2.7% will be reduced by the Productivity Adjustment of -0.7% for a net increase of 2.0% effective for claims with a date of service on or after January 1, 2026.
The 2.0% increase to the Medicare DMEPOS fee schedule means that O&P providers will be paid 2% more in 2026 than 2025 for the services you provide to Medicare beneficiaries. You will also see an increase in reimbursement for any private payor claims that use the prevailing Medicare fee schedule as the base for their negotiated rates. As a reminder, Medicare sequestration remains in effect and will continue to result in a 2% overall reduction in Medicare reimbursements, but the sequestration reduction is applied after calculation of the 2026 fee schedule meaning your 2026 reimbursement will still be 2% more than 2025 reimbursement rates.
Here is the link to the CMS announcement.
Questions regarding the 2026 Medicare DMEPOS Fee Schedule increase may be directed to Joe McTernan at jmcternan@AOPAnet.org or Devon Bernard at dbernard@AOPAnet.org.