Should You Adjust Your Fees This Year?

The 2026 landscape for chiropractic billing is shifting, making it essential for practitioners to review and adjust their fee schedules to avoid leaving revenue on the table. While Relative Value Units (RVUs) for standard chiropractic services are slightly reduced, a 3.26% increase in the Medicare conversion value ensures that most reimbursements remain flat or see a slight increase. The most significant "good news" for 2026 involves Evaluation & Management (E/M) services, which experienced an approximate 7% RVU increase, leading to a substantial boost in overall reimbursement value.Furthermore, clinics offering acupuncture should take note of a staggering 20% increase in RVU value since 2024. These updates are critical because many commercial plans, Veterans Affairs, and state workers’ compensation programs—such as those in Michigan, California, and North Carolina—benchmark their payment rates against Medicare’s RVU system. Expert Samuel A. Collins emphasizes that you must bill a higher rate to receive these increased payments. Because payers will only pay up to the billed amount, even if the allowable rate is higher, failing to update your fee schedule effectively results in lost revenue. Staying aligned with these 2026 updates is vital for maximizing practice reimbursement.