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MIPS MVP goes mandatory in 2029; QPP otherwise quiet

07/27/2026

In the 10th year of the Quality Payment Program (QPP), CMS proposes a substantial change for providers in the Merit-based Incentive Payment System (MIPS): Making the specialty-specific MIPS Values Pathways (MVP) version of reporting that has been optional for four years mandatory for all MIPS participants in 2029.

Expect new telehealth codes, modifiers and descriptors in 2027

07/27/2026

by: Julia Kyles, CPC

CMS did not receive external suggestions for new telehealth services in 2027, but it has five of its own, plus a revision to the telehealth critical care codes and new modifiers for telehealth services that are mandated by law. The agency also reiterated that the current telehealth waiver extensions will not expire until Dec. 31, 2027, in the proposed 2027 Medicare physician fee schedule.

Little changes can mean big dollars for Shared Savings ACOs

07/27/2026

by: Roy Edroso

A series of seemingly small technical changes to the Medicare Shared Savings Program (MSSP) can lead to major advantages for some participants, experts tell Part B News.

CMS seeks input on ‘redesigning’ primary care pay in the age of AI

07/27/2026

by: Julia Kyles, CPC

Stakeholders who want to help shape CMS policy should respond to the agency’s request for information (RFI) titled “Redesigning Primary Care to Make America Healthy Again,” in the proposed 2027 Medicare physician fee schedule.

Catch new file from CMS for top specialties by RVUs, enrollment

07/27/2026

by: Julia Kyles, CPC

In response to comments about its specialty impact table, CMS has created a file designed to “offer interested parties’ additional information that addresses concerns about the lack of granularity in our impact tables,” CMS wrote in the proposed 2027 Medicare physician fee schedule. To show how the impacts can vary, the agency created a file that “models the expected percentage change in total RVUs per practitioner."

Feds sharpen AI fraud tools; plan ahead, and fight if necessary

07/20/2026

by: Roy Edroso

Rumblings from CMS suggest that the agency and its associates plan to make greater use of artificial intelligence (AI) fraud-catching tools in days to come. Experts say you can look at the way AI parses data to prepare for audits that are informed by it.

Incident-to update: More Blue plans tighten policies for reporting, reimbursement

07/20/2026

by: Julia Kyles, CPC

Remind staff that they can’t assume a commercial payer’s incident-to policies will match Medicare’s. The latest examples come from Blue Cross Blue Shield plans in North Carolina and Michigan.

MGMA, AMGA report that provider compensation is up, but barely

07/20/2026

by: Roy Edroso

Two major medical practice organizations, the Medical Group Management Association (MGMA) and the American Medical Group Association (AMGA), recently released survey results on provider compensation data. Both see compensation rising, but slowly and unevenly, and generally agree that it doesn’t track with physician productivity, which by some measures can be said to have decreased.

Conversion factor dips as CMS proposes cuts, floats major coding updates

07/20/2026

by: DecisionHealth staff

Brace for impact: CMS announced a reduction to physician fees for CY 2027 that would, in aggregate, lower payments across the board. The conversion factor (CF), one of CMS’ primary ratesetting mechanisms, would drop between 1% and 2% depending on the professional fee setting.

Practices take modest approach to caregiver training after 2024 debut

07/20/2026

by: Richard Scott

Medical groups took a slow embrace of caregiver training services (CTS) after CMS rolled out three codes eligible for Medicare billing in 2024. But practices still cleared more than half of a million dollars in payments for the codes, hinting at greater potential ahead.

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