In July 2025, the Centers for Medicare & Medicaid Services (CMS) proposed sweeping changes to the Medicare Physician Fee Schedule for calendar year 2026. Among the most impactful updates is the launch of the Ambulatory Specialty Model (ASM)—a mandatory value-based payment program focused on heart failure and low back pain. Under this model, specialists in select metropolitan areas will be required to assume two-sided financial risk for episodes of care. Performance in ASM will be assessed using the Merit-Based Incentive Payment System (MIPS) Value Pathways (MVP) framework.
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