Medicare & Medicaid Programs; CY 2026 Payment Policies Under The Physician Fee Schedule

On July 16, 2025, the Centers for Medicare & Medicaid Services (CMS) published this document with its proposed calendar year (CY) 2026 payment policies under the physician fee schedule for Medicare and Medicaid programs. Among the proposals is a new approach, the Ambulatory Specialty Model (ASM), for managing services for Medicare beneficiaries with chronic health conditions.

The ASM is a mandatory payment model that would leverage the CMS Merit-based Incentive Payment System (MIPS) Value Pathways framework to target heart failure and low back pain. The model would enhance the quality of care and improve chronic disease management for beneficiaries . . .