H.R. 7520 — Efficiency Adjustment Delay Act

This section delays implementation of the work relative value unit (RVU) efficiency adjustment and related updates to the intraservice portion of physician time inputs for non-time-based services under the Medicare physician fee schedule (PFS)—as established in the CY2026 PFS final rule (90 Fed. Reg. 49266)—until January 1, 2030. (The PFS determines Medicare payments to physicians and other practitioners as the product of three RVUs—for work, practice expense, and malpractice—multiplied by a dollar conversion factor.) It further requires the Secretary of Health and Human Services, not later than two years after enactment, to report to specified congressional committees assessing the need for a one-time, across-the-board work RVU adjustment for services not revalued or reviewed in the prior 10 years; permits future implementation on or after January 1, 2030, if the report supports it and specified conditions are met (i.e., consultation with affected physician specialties, exclusion of recently revalued services, methodology restrictions tied to consumer price index increases, and a one-time limit only); and clarifies that the delay does not preclude revaluing misvalued codes or valuing new or revised codes. This section also modifies PFS conversion factor updates under SSA sec. 1848(d)(20) by increasing the 2026 update to the qualifying alternative payment model (APM) conversion factor to 1.24 percent (from 0.75 percent) and to the nonqualifying APM conversion factor to 0.74 percent (from 0.25 percent), reverting both to 0.75 percent and 0.25 percent, respectively, for 2027 and subsequent years. (Qualifying APM participants receive the higher update to incentivize value-based care arrangements.)