The new “One Big Beautiful Bill” (OBBB) brings a mix of significant tax benefits and status-quo policy for physicians and medical practice owners. Here’s what you need to know to navigate the new landscape.

The biggest win is on the tax front. Most medical practices are structured as pass-through entities, and you will benefit directly from the newly permanent and enhanced 23% Section 199A deduction for qualified business income. Furthermore, for those in high-tax states, the final law preserves the critical Pass-Through Entity Tax (PTET) workaround. This allows your practice to pay state income taxes at the entity level, making them fully deductible at the federal level and bypassing the individual SALT cap. This is a massive, multi-year benefit that will significantly lower the tax burden for many practice owners.  

On the reimbursement side, the news is less impactful. The OBBB provides only a minor, one-time 2.5% adjustment to the Medicare Physician Fee Schedule for 2026, which does little to address the long-term challenge of declining real reimbursement rates.  

However, in a positive step for modern practices, the law makes it permanently easier for patients with high-deductible health plans to use telehealth services before meeting their deductible. This solidifies the role of virtual care in your practice model.  

The key takeaway is that the OBBB is primarily a tax bill. The benefits for your practice’s financial health are substantial, but they will come from proactive tax planning, not from changes in Medicare policy.