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Medicare/CMSTraditional Medicare · Administrative · Medicare Programs · Cardiology, Pain Management, Internal MedicineHigh impact

2026-09-17 - Mandatory Ambulatory Specialty Model Final Participants

Effective date
Jan 1, 2027
Identified
Sep 29, 2026

Summary

CMS has released the final participant list for the mandatory Ambulatory Specialty Model (ASM) effective for the 2027 performance year. Specialists treating Medicare patients for low back pain or heart failure in outpatient settings who are selected must comply with all model requirements, including reporting required measures and attestations. Medicare Part B payments will be adjusted based on reported performance metrics.

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What to do

Action · 6 steps
01REQUIREMENTS: - Immediately: Billing team and providers must verify participation status by visiting the ASM Participants webpage (https://www.cms.gov/training-education/medicare-learning-network/newsletter/mln-connects-newsletter-september-17-2026) to determine if your practice has been selected for the mandatory ASM program.
02- Before 2027-01-01: If selected, participating providers must register for the virtual ASM Participant Office Hour on Wednesday, September 30, 2026, from 1–2 pm ET to understand model requirements.
03Attend training on all required reporting measures and attestations.
04- Before 2027-01-01: Billing team must implement workflow changes to capture and report required performance measures and quality attestations for low back pain and heart failure cases.
05Update billing software and encounter forms to track ASM-required data elements.
06- By 2027-01-01: Establish processes for submitting required measures and attestation reports to CMS as mandated by the ASM model.
If missed: Failure to comply with reporting requirements and model participation rules will result in adjusted (reduced) Medicare Part B reimbursement rates.

Original notice

2026-09-17 - Mandatory Ambulatory Specialty Model Final Participants
cms.gov · Always check the source before changing claims.
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