Is Prior Auth Slower in 2026? 44.0% of Practices Say Yes

Prior authorization turnaround is slower in 2026 for 44.0% of practices, according to MGMA's September 1, 2026 poll of 178 medical group leaders. Only 7.0% report faster turnaround, even though payers' own 2025 filings show median standard decisions of 0.9 days, per KFF.

The two numbers measure different things, and a practice manager needs both. The first describes what staff experience. The second describes the middle request in a payer's own data.

What the MGMA poll found

MGMA asked leaders whether payer prior authorization turnaround in 2026 was slower, the same or faster than in 2025. The poll drew 178 applicable responses.

Turnaround vs. 2025	Share of 178 responses
Slower	44.0%
About the same	40.0%
Faster	7.0%
Unsure	9.0%

Source: MGMA Stat poll, September 1, 2026.

The slower group is 37.0 percentage points larger than the faster group, and it is 6.3 times its size. Respondents who saw slower turnaround most often named status checks, peer-to-peer reviews and heavier documentation requirements. Respondents who saw faster turnaround named fewer payer authorization requirements, wider use of electronic submission tools and changes to their own workflows.

The poll follows the MGMA 2026 Regulatory Burden Report, in which 90.0% of practices said their prior authorization burden grew over the previous 12 months. MGMA published its prior authorization issue brief with that figure on April 28, 2026.

What payers reported to KFF

CMS-0057-F required certain payers to post prior authorization metrics on their websites, with the first reports due March 31, 2026. Those reports cover calendar year 2025. KFF published its analysis on August 13, 2026.

KFF reviewed 14 unique insurers across three markets. The Medicare Advantage insurers cover 25 million enrollees, or 69.0% of that market. The Medicaid managed care insurers cover more than 35 million enrollees, or 54.0%. The ACA Marketplace insurers cover 11 million enrollees, or 74.0%.

Market (2025 data)	Median standard decision	Median expedited decision	Standard denial rate	Denials overturned on appeal
Medicare Advantage	0.9 days	0.4 days	12.0%	67.0%
Medicaid managed care	0.9 days	0.8 days	14.0%	47.0%
ACA Marketplace	0.9 days	1.0 day	18.0%	43.0%

Source: KFF, "Prior Authorization Metrics Provide New Insights into Insurer Practices, but Gaps Remain," August 13, 2026.

Expedited requests were denied at lower rates than standard ones: 10.0% in Medicare Advantage, 12.0% in Medicaid managed care and 16.0% in the ACA Marketplace.

A median of 0.9 days is about 22 hours. The federal limit for a standard request is seven calendar days, so the middle request uses roughly one eighth of the allowed time. KFF notes that some insurers reported times in days and others in hours, and it converted hours to days to compare them.

Why practices and payers see different numbers

A median shows the middle request. Half of requests take longer, and the report does not say how much longer. KFF also notes that insurers report percentages, not the number of requests behind each metric, so a practice cannot tell how many requests sit in the slow half.

The federal clock covers one stretch of the process. Physicians Practice wrote on September 10, 2026 about the MGMA poll: "None of those sit inside the decision window the rule regulates." The bottlenecks respondents listed were status checks, peer-to-peer reviews and documentation requests. Staff feel those steps as turnaround, and a decision-time median does not count them.

The workload behind those steps is large. The AMA's 2025 survey of 1,000 physicians, released May 13, 2026, found that physicians complete an average of 40 prior authorizations per week and that physicians and staff spend 13 hours per week on them. That works out to 19.5 minutes per request. The same survey found 40.0% of physicians employ staff who work only on prior authorization.

Portals add to the time. In MGMA's March 2026 poll, 61.0% of practices said staff log into seven or more payer portals every week. MGMA's Stat summary also reports that 45.0% of practices named eligibility and prior authorization the most time-consuming phone tasks.

What to track in your own practice

The payer filings report one number per market. A practice can build one number per payer. Log four dates or counts for every request: the date staff submitted it, the date the payer decided, the number of status checks, and the number of peer-to-peer calls. Add a fifth field for documentation requests, and a sixth for the payer's name. Review the log by payer once a month.

Compare each payer's elapsed time with the federal windows. Medicare Advantage and select Medicaid and CHIP payers must decide expedited requests within 72 hours and standard requests within seven calendar days, according to MGMA. A request that exceeds either window then has a date record behind it, which makes a payer call or an escalation concrete.

The AMA figures give a baseline for staff hours. At 13 hours per physician per week, a five-physician practice spends about 65 hours a week on prior authorization. If a practice logs fewer or more hours than that, the gap shows where the workflow differs from the national average.

The next federal date is January 1, 2027, when payers must meet the prior authorization API requirements in CMS-0057-F. The MIPS Electronic Prior Authorization measure begins with the 2027 performance period for clinicians, according to CMS.

Sources

Talk to us

Fifteen minutes about your practice and the systems you run.

Book a demo