APMA leadership met with Elevance Health, the parent company for Anthem, to discuss their new Facility Administrative Policy addressing the use of nonparticipating care providers and the potential implications for podiatric physicians and patient access to foot and ankle care. The meeting followed APMA’s December 2025 letter to Elevance outlining concerns with the policy that penalizes Anthem-contracted facilities by up to 10 percent for using out-of-network providers for services.
APMAPAC has released its 2025 Annual Report, offering a comprehensive look into the activities, outcomes, and ongoing goals of the APMAPAC. As the only bipartisan arm that supports federal candidates aligned with the profession’s legislative priorities, APMAPAC plays a key role in strengthening podiatric medicine’s voice in Washington, DC.
Congressional leaders have unveiled a new bipartisan package of health-care reforms, which includes issues APMA has advocated for. The package is tied to a larger $1.2 trillion government spending package that funds the Department of Health and Human Services (HHS), Department of Labor, and other agencies through fiscal year 2026.
The House Ways & Means Committee and Energy & Commerce Health Subcommittee hosted a concurrent congressional hearing focused on health insurance practices and affordability last week. Before the hearing, APMA collaborated with both committees to submit questions for lawmakers to ask. Additionally, APMA submitted joint statements to the committees.
The APMA Board of Trustees has approved two new position statements addressing persistent challenges podiatric physicians face in the Medicare Advantage (MA) program and with prior authorization (PA) processes. Together, these statements reinforce APMA’s commitment to protecting patient access to medically necessary foot and ankle care while reducing administrative burdens that delay treatment and undermine physician decision-making.
Last week, APMA responded to direct bipartisan outreach from the GOP and Democratic Doctors Caucus for recommendations to modernize the Merit-based Incentive Payment System (MIPS) and improve future Center for Medicare and Medicaid Innovation (CMMI) models. APMA focused its comments on supporting the American Medical Association’s Data-Driven Performance Payment System (DPPS) proposal, which would replace key elements of MIPS.
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.
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.
APMA would like to notify members that another round of field testing for the Non-Pressure Ulcer Episode-Based Cost Measure (NPUECM) is now open 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.
The deadline to provide comments on CPME college document revisions is February 15. 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.
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.
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.
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.