CMS Prior Authorization Demonstration
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.
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Government Shutdown Information
Unfortunately, Congress was unable to reach a funding consensus before the end of the federal fiscal year (September 30), and the U.S. federal government shutdown 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.
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ICD-10-CM Changes Related to Podiatry
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.
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MATE Act Fix
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.
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2024 MIPS
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 will be available in approximately one month.
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State Advocacy Forum
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.
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Local Advocacy with Congress
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.
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Skin Substitute Payments
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.
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Insurers' AI Practices
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.
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Decision on ACGME
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.
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Physician Fee Schedule
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.
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State Advocacy Forum
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.
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