On Demand: 2026 CMS Final Rules Recap: Insights for the Year Ahead in Cardiovascular Care-Webinar Recording

Video Transcription

Video Summary

This 26th Medicare CMS Final Rule Recap webinar, hosted by Nicole Knight of Medaxium and featuring experts from the American College of Cardiology (ACC), reviews key updates for 2025 impacting cardiovascular care. Highlights include:<br /><br />- Medicare Physician Fee Schedule: For the first time, two conversion factors exist, with a 3.77% increase for Advanced Alternative Payment Model (AAPM) participants and 3.25% for others, including a one-time 2.5% boost from legislation. Cardiovascular services overall see a ~1% increase, but facility-based services face a ~7% payment cut due to changes in indirect practice expense allocations and a new 2.5% efficiency adjustment applied broadly, except to new CPT codes. Some procedural codes like left atrial appendage occlusion were significantly devalued, while new PCI and lower extremity revascularization codes avoided reductions.<br /><br />- Ambulatory Specialty Model: A new CMS payment model launching in 2027 targets cardiologists with heart failure patients, potentially replacing MIPS participation. Details remain uncertain.<br /><br />- Telehealth: Congress extended telehealth flexibilities through January 2025, including permanent virtual direct supervision and cardiac rehab telehealth coverage, but future extensions remain uncertain pending legislation.<br /><br />- Quality Payment Program (QPP): Performance thresholds remain stable; revisions made to MVP measures affecting cardiology quality reporting.<br /><br />- Hospital Outpatient and Ambulatory Surgery Center (ASC) Payments: OPS payments rose 2.6% overall; the inpatient-only list will phase out over three years. Major win for ASC is inclusion of EP studies, ablations, PCI, and cardioversion on the ASC covered procedure list, though state regulations may impact implementation. Diagnostic testing payments saw mixed adjustments linked to site of service considerations, with ongoing discussions about site neutrality.<br /><br />The presenters addressed audience questions about real-time audiovisual supervision, data sharing requirements, and fee schedule variability by location and coding mix. Resources and upcoming educational webinars were announced to assist providers with adapting to these complex changes.

Keywords

Medicare CMS Final Rule 2026

Cardiovascular care updates 2025

Medicare Physician Fee Schedule changes

Advanced Alternative Payment Model increase

Ambulatory Specialty Model 2027

Telehealth extension 2025

Quality Payment Program revisions

Hospital Outpatient Surgery Center payments

ASC covered cardiology procedures