Background: Representatives Ron Estes (R-KS-04) and Tom Suozzi (D-NY-03) recently introduced H.R. 7520, the Efficiency Adjustment Delay Act. This bill would delay a new policy included in the Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) final rule, the efficiency adjustment (EA). This policy applies a modest 2.5% reduction to a portion of Current Procedural Terminology (CPT) codes, specifically for most non-time-based services. A CPT code consists of 3 relative value units (RVUs): physician work, practice expense, and malpractice. The EA applies to a portion of the physician work RVU, specifically to the intra-service portion (which is only one of three components of the physician work RVU).  

The idea behind the EA is that over time, with improvements in technology and workflows, physicians performing certain services, such as procedural services, will end up improving their efficiencies in care, and payment should reflect that. This adjustment would account for those efficiencies over time. The EA policy does not apply to evaluation and management (E/M) codes and time-based codes that are frequently billed by primary care practices. ACP strongly supports the EA policy as it would fix outdated payment assumptions, helping to preserve Medicare and protect patients’ access to high-quality primary care. 

Action Requested: Please email your members of Congress to ask them to vote NO on H.R. 7520, the Efficiency Adjustment Delay Act. A sample message has been provided for you that can be personalized. Please contact Shuan Tomlinson at stomlinson@acponline.org with any questions about this campaign. Thank you for your continued advocacy.