Guide · Updated Jul 6, 2026
The 2026 Medicare Conversion Factor
Starting with the CY2026 Physician Fee Schedule, there is no longer a single national conversion factor — CMS now publishes two: a higher rate for clinicians who qualify as participants in an Advanced Alternative Payment Model (QP) and a lower rate for everyone else (non-QP). Getting a 2026 rate right means knowing which one applies.
Current conversion factor — Q3 2026 release
- Standard (non-QP)
- $33.4009
- Qualifying APM participant (QP)
- $33.5675
From the Q3 2026 PFS release as published by CMS — dollars per total geographically-adjusted RVU.
Why there are two conversion factors now
The MACRA incentive payment that used to reward Advanced APM participation with a separate 5% bonus expired, and CY2026 rulemaking replaced it with a structural split baked directly into the PFS formula itself: QPs get a higher conversion factor, non-QPs get a lower one, applied to the exact same RVUs. It is no longer a bonus paid on top — it is a different multiplier from the start.
What changes and what does not
A code's work, practice expense, and malpractice RVUs, and its GPCIs, are identical for QP and non-QP clinicians — only the final conversion-factor multiplication differs. A rate lookup that ignores QP status silently defaults to one or the other, which is a real (if small) misstatement for every affected clinician, not a rounding error.
Finding out which one applies to you
QP status is determined per clinician (by NPI) based on Advanced APM participation thresholds measured in a prior period — it is not something a fee-schedule lookup tool can infer from a code or a locality. If you don't already know your QP status from your APM's participation notice, that determination has to come from CMS or your APM, not from the RVU files.
How this site handles it
Every rate lookup here defaults to the standard (non-QP) conversion factor — the figure CMS publishes as the headline number — and exposes an explicit flag to request the QP conversion factor instead once you know your status. Both figures are shown as auditable, release-stamped facts, never blended into a single guessed average.
Frequently asked
Is the QP conversion factor always higher?
Yes, for CY2026 the qualifying-APM-participant (QP) conversion factor is higher than the standard (non-QP) conversion factor — they apply to the same RVUs, so the QP figure produces a higher payment for every otherwise-identical code.
Do I have to tell a rate lookup my QP status?
Yes — it can't be inferred from the code, locality, or setting. A lookup that doesn't ask defaults to the standard (non-QP) conversion factor.
Does the QP/non-QP split affect the GPCIs or RVUs?
No. Only the final conversion-factor multiplier differs; the RVU components and geographic adjustments are the same for both.
Related
Sources
Written from primary CMS sources — see how we source, compute, and verify everything on this site.