Most of it came from H.R.1, a.k.a. Public Law No: 119-21, the “One Big Beautiful Bill Act.”

H.R.1 became law 7/4/2025.

I previously reported final 2026 national payment amounts (NPA) for the ten services most commonly provided by psychologists, and group therapy, based on the Final Rule for the Physician Fee Schedule (PFS).

The Final Rule included a Conversion Factor (CF) of 33.4009, a 3.3% increase over the 2025 CF of 32.3465. Given that the CF had declined the previous five years in a row, the 2026 CF is a substantial reversal of the prior trend. This had the effect, for example (and taking into account other adjustments to specific psychological service codes), of contributing to a 2025-2026 increase from $154 to $167 for a key service (60 minute psychotherapy).

More detailed review of the 2026 Final Rule shows factors contributing the CF increase, at least one of which may surprise those who follow these trends.

While .25% of the increase is due to a prior legislative update, and .49% is due to a “budget neutrality adjustment,” fully 2.5% of the increase in the CF is due to a temporary boost provided in H.R.1. Here is the language in the Final Rule, and in H.R.1 at SEC. 71202.

Late-in-the-year (and early in following calendar year) budget adjustments to the PFS are not new. Indeed at least five such adjustments have occurred before. But such an adjustment might not have been widely appreciated or reported, and is particularly surprising given the budgetary gridlock emphasizing cutbacks that has been going on for some months and continuing up until now.

Of course this temporary boost is scheduled for 2026 only, so the whole “negotiation” will begin again by July or so of next year.

Sources:  2026 Final Rule, CMS Fact Sheet, A Halloween Treat