APMA Health Policy Advisor Jeffrey Lehrman, DPM, CPC, recorded an extended video detailing new information available from CMS on the Wasteful and Inappropriate Service Reduction (WISeR) Model. Dr. Lehrman outlines several aspects of the WISeR Model, including its objectives, the timeline for implementation, and the impacted states.
Five of seven Medicare Administrative Contractors (MACs) have proposed Local Coverage Determinations (LCDs) that would restrict coverage for peripheral nerve blocks (PNBs). APMA has coordinated a national response to protect access to these essential services. Impacted MACs include CGS, NGS, Noridian, Palmetto, and WPS.
APMA has redesigned its eAdvocacy Action Center to make it easier than ever for members, patients, and students to engage in grassroots advocacy. The updated platform empowers APMA members to quickly engage their members of Congress and influence federal health policy. It also provides tools to take action on critical state legislation.
Note to APMA members that received the October 21 Weekly Focus: Shortly after the Weekly Focus was finalized, CMS updated its guidance and lifted most claims holds. The claims hold has now been lifted for claims paid under the Medicare Physician Fee Schedule, ground ambulance transport claims, and Federally Qualified Health Center (FQHC) claims.
APMA partnered with 17 other societies representing providers, patients, and suppliers to send a letter to all four DME MACs requesting that they revise "Therapeutic Shoes for Persons with Diabetes – Policy Article" (A52501). The goal is to restore beneficiary access to this important Medicare benefit.
APMA continues its partnership with the Alliance for Gout Awareness (AGA): On October 16, APMA joined fellow member organizations for the 2025 AGA Stakeholder Meeting in Washington, DC. The event brought together patient advocates, clinicians, researchers, and policy professionals to advance the coalition's mission of improving public understanding of gout and empowering patients to better manage the condition.
APMA submitted comments to CMS in response to a new prior authorization demonstration that will apply to certain services performed in ambulatory surgical centers across 10 states beginning in December. APMA's comment letter to CMS outlines our concerns on barriers to care, provider burden, and duplicative oversight.
Unfortunately, Congress was unable to reach a funding consensus before the end of the federal fiscal year (September 30), and the US federal government shut down as of 12:01 a.m. on October 1, 2025. The Medicare Program will continue during a lapse in appropriations. APMA believes this means there will be continuation of claims processing and payment; however, payments may be slower. Medicare telehealth will also expire.
The ICD-10-CM code set for 2026 takes effect October 1, 2025: All members should be using the new code set for services performed on or after this date. The new code set includes 487 new code additions, 28 deletions, and 38 modifications. Some of these are pertinent to foot and ankle care, including changes involving lower extremity ulcers, diabetes, and more.
As a direct result of APMA's advocacy efforts, the SUPPORT for Patients and Communities Reauthorization Act of 2025 now allows podiatry organizations to provide mandatory training on the treatment and management of patients with substance use disorders.
CMS has released Merit-based Incentive Payment System (MIPS) performance feedback and final scores for the 2024 performance year. Your 2024 final score impacts your Medicare Part B payments in 2026, and 2026 MIPS payment adjustments are now available.
Leaders from across the country came together September 18–19 in Boston, MA, for APMA's 2025 State Advocacy Forum, co-hosted by the Massachusetts Foot and Ankle Society (MFAS). The forum provided two days of learning, collaboration, and strategy-building on pressing state-level issues, from scope of practice to payer challenges.
APMA co-hosted an event in support of Rep. Brendan Boyle (D-PA-02), a member of the House Ways & Means Committee, and hosted an event supporting Diabetes Caucus Co-Chair Rep. Diana DeGette (D-CO-01). Rep. DeGette serves as the Ranking Member of the House Energy & Commerce's Health Subcommittee and has been a consistent champion of the podiatry profession throughout her career.
APMA submitted comments to the CMS in response to the proposed rule, Hospital Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center Payment Systems [CMS-1834-P]. APMA's comments focused on protecting patient access to skin substitutes, which are essential for the treatment of complex wounds such as diabetic foot ulcers.
APMA submitted comments to the US House Committee on Energy & Commerce to highlight the potential benefits and significant risks of integrating artificial intelligence (AI) into clinical practice, including administrative functions, and AI's growing use in coverage determinations and prior authorization.
In response to outreach from individual members of the podiatric community, ACGME agreed to explore the possibility of offering accreditation to podiatric medicine, if there was interest from the podiatric community. APMA gathered feedback on the pros and cons of participating in an exploratory process with ACGME and determined that this question requires significantly more input from the profession and would ultimately need to be vetted by our House of Delegates.
APMA submitted comments to CMS in response to the proposed MPFS. APMA expressed appreciation for some of CMS' proposals, including an estimated 4 percent payment increase for podiatry. APMA expressed strong opposition to several proposals related to skin substitute payment policy and a proposed efficiency adjustment.
APMA is co-hosting the State Advocacy Forum with the Massachusetts Foot and Ankle Society (MFAS) in Boston on September 18–19. This signature event convenes component leaders from across the country for two days of learning, collaboration, and strategy-building on issues affecting states, from scope of practice to payer challenges.
The president of the American Orthopaedic Foot and Ankle Society (AOFAS) recently published an editorial in which he exhorts his colleagues to engage with hospital credentialing committees as well as lawmakers and health-care leaders about the differences between orthopedic and podiatric training “to prevent scope creep.” The article is riddled with misleading messages, exaggerations, and outright falsehoods. APMA responded and set the record straight: Podiatry is not just protecting musculoskeletal care—it is advancing it.
APMA submitted a letter to Cigna calling on it to withdraw its Evaluation and Management Coding Accuracy Policy (R49), scheduled for implementation on October 1, 2025. The new policy would automatically downcode higher-level E/M claims based on diagnosis codes instead of physician documentation. This would directly conflict with federal rules and AMA CPT guidance.