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Physician Fee Schedule Medicare

Maynard Nexsen

Understanding CMS’ Proposed Physician Payment Rule for 2026

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On July 14, 2025, the Centers for Medicare & Medicaid Services (CMS) unveiled its proposed rule for the 2026 Medicare Physician Fee Schedule (PFS), aiming to enhance the quality of care for Medicare beneficiaries while...more

McDermott+

CMS releases CY 2026 Physician Fee Schedule Proposed Rule

McDermott+ on

On July 14, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B [CMS-13271]...more

McDermott+

Digesting a giant reg: the CY 2026 Medicare Physician Fee Schedule proposed rule

McDermott+ on

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2026 Medicare Physician Fee Schedule (PFS) proposed reg. Stakeholders have highly anticipated the release of this reg, as it...more

Holland & Knight LLP

CMS Releases CY 2026 Medicare Physician Fee Schedule Proposed Rule

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on July 14, 2025, issued the calendar year (CY) 2026 Proposed Rule, which proposes payment policies and other outpatient services covered under Medicare Part B. Comments are...more

McDermott+

The ongoing saga of the PFS conversion factor: will it get fixed?

McDermott+ on

July 2, 2025 – There has been a lot of talk recently about the future of the Medicare Physician Fee Schedule (PFS) conversion factor (CF) – the standardized dollar amount used to convert relative value units (RVUs) into...more

Lathrop GPM

Where To, Medicaid? House Legislation Makes Significant Changes; Senate Future is Uncertain

Lathrop GPM on

On May 22, 2025, after a marathon markup session, the U.S. House of Representatives passed a bill containing significant proposed changes to the Medicaid program....more

McDermott+

A Preview of the Preview: Our CY 2026 PFS Proposed Rule Webinar Is Next Wednesday

McDermott+ on

It’s getting hot outside, which means that the summer regulatory season is almost upon us. In June or July, the Centers for Medicare & Medicaid Services (CMS) will release proposed regs impacting Medicare payments in...more

McDermott+

Healthcare Preview for the Week of: April 7, 2025

McDermott+ on

Final Week Before Easter Recess - Focus this week on Capitol Hill will remain on reconciliation, as Republicans aim to pass the unified budget resolution in the House before leaving on Thursday for the two-week Easter...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - March 2025 #2

News Briefs - Analysts Predict Increase in 2025 P.E. Healthcare Dealmaking - Following a steady, but modest, year of private equity dealmaking in healthcare, 2025 could see higher levels of activity as market conditions...more

Tucker Arensberg, P.C.

2025 Medicare Final Rule Highlights

Tucker Arensberg, P.C. on

CMS issued its Final Rule for the 2025 Medicare Physician Fee Schedule in November. Originally published in the Allegheny County Medical Society (ACMS) Bulletin - December 2024....more

McDermott Will & Emery

New Year Brings Material Changes to Medicare Overpayment Rule

McDermott Will & Emery on

The Centers for Medicare and Medicaid Services (CMS) finalized material changes to the overpayment rules for Medicare Parts A, B, C, and D effective January 1, 2025. These changes create new ambiguity and practical challenges...more

McDermott+

Regulatory Implications of the Continuing Resolution Healthcare Package

McDermott+ on

Earlier this week, Congress released the text of a continuing resolution that includes a more-robust-than-anticipated healthcare package. While the bill’s primary purpose is to keep the government open through March 14, 2025,...more

Snell & Wilmer

Deadline Approaches for Expiring Medicare Telehealth Waivers: What Providers Should Know

Snell & Wilmer on

During the COVID-19 pandemic, both federal and state governments enacted a host of laws and implemented flexibilities to ensure health care providers, hospitals, and health systems could move traditional brick-and-mortar care...more

Whiteford

Navigating New Medicare Overpayment Rules and Practical Tips to Comply

Whiteford on

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) finalized the Medicare regulations interpreting the federal 60-day overpayment refund requirement (the Overpayment Statute) for Medicare Parts A and B as...more

Baker Donelson

2025 Medicare Physician Fee Schedule: Payment and Overpayment Policies

Baker Donelson on

On December 9, 2024, the Centers for Medicare & Medicaid Services' (CMS's) Calendar Year 2025 Physician Fee Schedule Final Rule (the Final Rule) was published in the Federal Register. The Final Rule includes noteworthy...more

Bass, Berry & Sims PLC

CMS Finalizes Virtual Direct Supervision Extension and Rule Changes

Bass, Berry & Sims PLC on

On November 1, the Centers for Medicare & Medicaid Services (CMS) finalized its proposal to extend virtual direct supervision—i.e., the ability to provide direct supervision through real-time, audio-visual technology (rather...more

Alston & Bird

Potential Medicare Physician Fee Schedule Reform in the Last Weeks of the 118th Congress

Alston & Bird on

A flurry of bills to reform the Medicare Physician Fee Schedule (PFS) faces the lame duck Congress. Our Health Care Group investigates how those reforms could take shape and which, if any, could find their way through the...more

Bass, Berry & Sims PLC

New CMS Policies Position the MSSP for Expansion and Increased Savings

Bass, Berry & Sims PLC on

New policies tucked into the Centers for Medicare and Medicaid Services’ (CMS) 2025 Medicare Physician Fee Schedule Rule (Final Rule) will likely spur increased Accountable Care Organization (ACO) participation in the...more

Robinson+Cole Health Law Diagnosis

CMS Finalizes Standard for Identifying Overpayments and Grace Period for Investigations of Related Overpayments

As part of its 2025 Physician Fee Schedule Final Rule (PFS Rule), the Centers for Medicare & Medicaid Services (CMS) finalized two crucial updates to federal Medicare overpayments regulations (sometimes referred to as the...more

Tucker Arensberg, P.C.

Medicare Telehealth Reimbursement Update

Tucker Arensberg, P.C. on

Our Introduction to Telehealth, Technology and Federal Enforcement chapter was published in the Thomson Reuters 2025 Health Law Handbook.  It reviewed a number of telehealth Medicare revisions, both permanent and temporary,...more

King & Spalding

CMS Makes Modifications to the Medicare Shared Savings Program

King & Spalding on

In its Final Rule for the 2025 Medicare Physician Fee Schedule, CMS announced changes to the Medicare Shared Savings Program (the Program) targeted at incentivizing providers to both enroll and stay in the Program. The Final...more

Bass, Berry & Sims PLC

CMS Bolsters Primary Care with Advanced Primary Care Management Coverage

Bass, Berry & Sims PLC on

On November 1, the Centers for Medicare & Medicaid Services (CMS) filed its Medicare Physician Fee Schedule (PFS) final rule (Final Rule) for calendar year (CY) 2025. As part of the Final Rule, CMS finalized Medicare coverage...more

King & Spalding

CMS Issues Final 2025 Calendar Year Medicare Physician Fee Schedule Final Rule

King & Spalding on

On November 1, 2024, CMS issued a rule finalizing changes to Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B policies effective on or after January 1, 2025 (the Final Rule). Section 1848 of...more

Benesch

Dialysis & Nephrology Digest - November 2024

Benesch on

RPA Perspective: 2025 Medicare Fee Schedule and ESRD PPS Final Rules—Highlights for Nephrology - The final rule for the 2025 Medicare Physician Fee Schedule was released on November 1, and the highlights from the rule...more

Foley & Lardner LLP

Health Policy: Expected Movements in the Lame Duck Session – November/December 2024

Foley & Lardner LLP on

Congress returned to Washington this week with just five weeks left in this year’s legislative calendar. With a Continuing Resolution (CR) that expires December 20, 2024, either a year-end spending package or a new Continuing...more

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