About APMA

2026

January 9, 2026

Deadline to Provide Comments on CPME College Document Revisions Is Closing Soon

CPME College Document Revisions

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.


January 5, 2026

Non-BLA Skin Substitute Wastage Payment Change

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.


January 5, 2026

APMA Advocacy Win: CMS Removes CPT® 11042 from WISeR Model

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.


January 5, 2026

UnitedHealthcare Radiology Billing Update: New Reporting Requirements

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.


4 of 4 total pages