CMS finalized a -2.5% “efficiency adjustment” that applies to work RVUs (and the intraservice portion of physician time) for non-time-based services in 2026. CMS’ stated rationale is that time assumptions for many services are likely overvalued because clinicians and technology have become more efficient over time. CMS calculated the adjustment using the sum of the past five years of the Medicare Economic Index (MEI) productivity adjustment, resulting in the -2.5% factor.

Policy Insights

Download MGMA Government Affairs’ Work RVU Efficiency Adjustment resource, an MGMA member-exclusive benefit, for an easily downloadable reference on this topic.

For medical group practices, the ripple effects will vary:

• Most exposed are groups with formulaic wRVU-based incentives (straight conversion factor, tiers, thresholds), especially where a large share of wRVUs come from non-time-based procedural/imaging codes, and where commercial contracts/benchmarks are linked to wRVU counts.
• Less exposed are groups whose comp is salary-heavy, panel-based, or E/M-dominant, and groups that already use hybrid measures where wRVUs are only one of a handful of inputs.

The most-impacted practices risk a trust and retention problem: clinicians may feel like they’re doing the same work for less credit and less pay. In this article, we’ll examine what’s changed, who is most exposed across six high-volume specialties, and what practice leaders should consider to respond.