Medicare/CMSMedium ImpactPrior Auth

2026-04-23 - 2026 CMS Interoperability Standards & Prior Authorization Proposed Rule Resources

Published April 23, 2026

AI Summary

CMS released new resources for the 2026 Interoperability Standards and Prior Authorization Proposed Rule, with comment period ending June 15. The update includes technical workflows, proposed metrics, and implementation guides for new prior authorization requirements and API standards.

Action Required

By June 15, 2026: Review the CMS-0062-P proposed rule resources and submit comments if desired. Billing teams should review technical workflows and proposed metrics to prepare for future prior authorization API requirements. Monitor for final rule publication to understand implementation timelines.

Affected Billing Codes

G0136G987187494Z23

Plan Types

All Plans

Specialties

all-specialties

2026-04-23 - 2026 CMS Interoperability Standards & Prior Authorization Proposed Rule Resources | Medicare/CMS | PolicyChanges.app