Efficiency Adjustment Delay Act

Section 1848(c) of the Social Security Act (42 U.S.C. 1395w–4(c)) is amended by adding at the end the following new paragraph:

The Secretary may not implement the policy established in the final rule published on November 5, 2025 (90 Fed. Reg. 49266 et seq.), that establishes an efficiency adjustment to work relative value units, and makes corresponding updates to the intraservice portion of physician time inputs for non-time-based services, before January 1, 2030.

Not later than 2 years after the date of the enactment of this paragraph, the Secretary shall submit to the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives, and to the Committee on Finance of the Senate, a report containing an assessment of whether it is necessary to apply a one-time, across-the-board adjustment to work relative value units, and to make corresponding updates to the intraservice portion of physician time inputs for non-time-based services, with respect to services that have not been revalued or reviewed within the 10-year period preceding the calendar year in which such one-time adjustment would be applied. Such report shall include supporting evidence for such assessment.

Subject to clause (ii), in the case that the report under subparagraph (B) supports the implementation of the efficiency adjustment described in subparagraph (A), the Secretary may implement such adjustment on or after January 1, 2030, if the following conditions are met:

(I) Before implementing such adjustment, the Secretary consults with representatives of physician specialties affected by the potential implementation of such adjustment.

(II) The Secretary does not implement such adjustment with respect to services that have been revalued or reviewed within the 10-year period preceding the calendar year in which such one-time adjustment would be applied.

(III) The Secretary establishes a methodology for calculating such adjustment that does not rely on a factor that is used for determining productivity relative to inflation unless the update to the nonqualifying APM conversion factor under section 1848(d) for the year in which the one-time adjustment would be applied is greater than or equal to the percentage increase in the consumer price index for all urban consumers (all items; United States city average) over the previous year.

The Secretary may not implement such an efficiency adjustment more than once.

Nothing in subparagraph (A) shall be construed to prevent the Secretary from revaluing misvalued codes for specific services or assigning values to new or revised codes for services.

Section 1848(d)(20) of the Social Security Act (42 U.S.C. 1395w–4(d)(20)) is amended—

(1) by striking 0.75 percent and inserting 1.24 percent;

(2) by striking 0.25 percent and inserting 0.74 percent;

(3) by striking For 2026 and each subsequent year and inserting the following:

For 2026

(3) ; and

(4) by adding at the end the following new subparagraph:

For 2027 and each subsequent year, the update to the qualifying APM conversion factor established under paragraph (1)(A) is 0.75 percent, and the update to the nonqualifying APM conversion factor established under such paragraph is 0.25 percent.