2025 MIPS Performance Year Reporting Is Open
The Centers for Medicare & Medicaid Services (CMS) has opened data submission for the 2025 performance year of the Quality Payment Program (QPP). Data can be submitted and updated until March 31 at 8 p.m. ET. APMA encourages members to submit their 2025 MIPS performance period data early during the submission period.
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USPS Postmark Changes
Podiatrists submitting time-sensitive materials by mail may be affected by changes to how the U.S. Postal Service (USPS) postmarks mail. Effective December 24, 2025, USPS postmarks now reflect the date mail is processed instead of the date it is dropped off. With mail processing becoming more centralized, delays between drop-off and postmarking may become more common.
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Prepare for 2026 Field Testing for NPUECM
APMA would like to notify members about another round of field testing for the Non-Pressure Ulcer Episode-Based Cost Measure (NPUECM) that will open on January 29 and run through February 27. Some members may receive a Field Test Report through their QPP Portal account; APMA requests that any members who receive a report to share it with APMA, so we can better advocate for you.
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CPME College Document Revisions
The deadline to provide comments on CPME college document revisions is February 1. The revised documents and a summary of changes are available for review on the CPME webpage. A survey to obtain feedback on the Draft 1 documents is also available online.
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Non-BLA Skin Substitute Wastage Payment Change
CMS has clarified that providers may no longer bill Medicare for wastage associated with the use of non-BLA skin substitute products as of January 1. The JZ and JW Modifiers should no longer be used for skin substitute application for Medicare beneficiaries.
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CMS Removes CPT® 11042 from WISeR Model
Following APMA's formal request in October 2025, the Centers for Medicare and Medicaid Services (CMS) released an updated version (Version 3.0) of the WISeR Model Provider and Supplier Operational Guide which removes CPT® 11042 (debridement of subcutaneous tissue) from Appendix B.
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UnitedHealthcare Radiology Billing Update
Starting April 1, when the same provider bills an E/M service and a global radiology code for the same patient on the same date, UnitedHealthcare will require a full written interpretation and report to separately reimburse the professional component of the radiology service. If no written report is submitted, the professional component of the global radiology code will not be reimbursed separately and time spent reviewing the radiology images will be bundled into the payment for the E/M service.
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CMS Withdraws Skin Substitute LCDs
CMS announced that A/B Medicare Administrative Contractors (MACs) are withdrawing the Local Coverage Determinations (LCDs) for Skin Substitute Grafts/Cellular and Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers. These LCDs were scheduled to take effect on January 1, 2026. With the withdrawal of these LCDs, there are no changes to skin substitute coverage for Part B Medicare beneficiaries in the new year.
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APMA Meets With Aetna
APMA advocacy staff met with Aetna leadership as part of APMA's ongoing quarterly discussions with the insurer. The conversation focused on prior authorization, documentation and coding oversight, and emerging coverage policies relevant to podiatric physicians.
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Administrative Burdens for Diabetic Shoes
APMA leadership and staff met with officials from CMS, including representatives from the Center for Clinical Standards and Quality and the Center for Program Integrity, to discuss access barriers related to therapeutic shoes for persons with diabetes (TSD). APMA highlighted concerns that current DME MAC requirements for therapeutic shoes are overly burdensome and go beyond what is required under Medicare statute: This ultimately results in significant delays and reduced access for beneficiaries.
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New Skin Substitute Resource Page
Members can find all the information related to skin substitutes coverage and payment on APMA’s new Skin Substitute Resource Page, which includes detailed videos covering the changes, the most current information on the future effective LCDs (and related coding and billing articles), information on the WISeR Model, and more. The most recently recorded video (Skin Substitute Policies Scheduled to Take Effect January 1, 2026) will be updated once the MACs have released final data.
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Interstate Podiatric Medical Licensure Compact
APMA is pleased to announce its formal endorsement of the Federation of Podiatric Medical Board’s (FPMB) initiative, the Interstate Podiatric Medical Licensure Compact. Following a vote by the APMA Board of Trustees, APMA submitted a support letter to the FPMB, affirming the APMA’s commitment to advancing this important licensure modernization initiative.
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