Lexology November 14, 2025
Key Takeaways:
- ASM is a mandatory alternative payment model for certain specialists treating low back pain and/or heart failure, running from Jan. 1, 2027 through Dec. 31, 2033, and applies to individual clinicians who meet CMS’s eligibility criteria.
- Medicare Part B payments for covered professional services will be adjusted up or down using a payment multiplier derived from each clinician’s ASM performance score.
- Clinicians should prepare now by familiarizing themselves with the participation requirements, enhancing care coordination, upgrading technology, and training staff to meet reporting and interoperability requirements.
On Oct. 31, the Centers for Medicare & Medicaid Services (CMS) released the 2026 Medicare Physician Fee Schedule Final Rule, wherein it established the Ambulatory Specialty Model (ASM)...
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