The “One Big Beautiful Bill Act” (OBBBA) that was passed on July 4^th included a one-time 2.5% update to the Medicare Physician Fee Schedule (MPFS) for CY2026. ASRA Pain Medicine was one of 75 health care organizations that advocated for an update in the MPFS as part of the massive legislative funding package.

The multidisciplinary coalition of organizations, led by the American Association of Neurological Surgeons, urged legislators to include a permanent, annual inflationary update as part of the funding package. The organizations proposed tying the MPFS to the Medicare Economic Index to help ensure predictable annual reimbursement levels.

While that provision was not included in the legislation, the 2.5% update is still seen as a positive development after five years of conversion factor reductions, including a 2.83% cut to the conversion factor for CY2025.

ASRA Pain Medicine will continue to advocate for fair reimbursement rates as concerns have been raised about potential additional budgetary adjustments. Experts have said the OBBBA’s overall spending could trigger the Pay-As-You-Go Act of 2010, which was designed to automatically reduce spending—up to 4% annually for Medicare—to offset legislation that increases the federal deficit. Medicare advocates are expected to push for another law to waive or suspend those cuts.

The Congressional Budget Office estimated that the OBBBA will result in over $1 trillion in federal healthcare spending costs over the next decade, mostly targeting Medicaid and the Children’s Health Insurance Program (CHIP).