1. Short title This Act may be referred to as the Physician Fee Schedule Update and Improvements Act . 2. Extending floor for work geographic index Section 1848(e)(1)(E) of the Social Security Act ( 42 U.S.C. 1395w–4(e)(1)(E) ) is amended by striking January 20, 2024 and inserting January 1, 2025 . 3. Increasing support for physicians and other practitioners in adjusting to Medicare payment changes Section 1848(t)(1)(D) of the Social Security Act ( 42 U.S.C. 1395w–4(t)(1)(D) ) is amended by striking 1.25 percent and inserting 3 percent . 4. Extending incentive payments for participation in eligible alternative payment models (a) In general Section 1833(z) of the Social Security Act ( 42 U.S.C. 1395l(z) ) is amended— (1) in paragraph (1)— (A) in subparagraph (A)— (i) by striking In the case and inserting Subject to subparagraph (E), in the case ; (ii) by striking ending with 2025 and inserting ending with 2026 ; and (iii) by inserting and 2026 after with respect to 2025 ; and (B) by adding at the end the following new subparagraph: (E) Special payment rule for 2026 (i) In general Subject to clause (ii), with respect to an amount payable under subparagraph (A) for 2026 to an eligible professional who is a qualifying APM participant for such year, such amount shall be reduced, in the case such participant has received payment under such subparagraph— (I) for at least 4 years but fewer than 7 years, by 34 percent