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2027 MPFS Comments

APMA submitted comprehensive comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed 2027 Medicare Physician Fee Schedule, advocating for policies that support podiatric practices and protect patient access to care

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Topical Oxygen Therapy Coverage

On September 5, APMA submitted comments on a proposed DME MAC Local Coverage Determination (LCD) addressing Medicare coverage of topical oxygen therapy (TOT) for certain nonhealing diabetic foot ulcers.

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Regence BlueShield Withdraws Modifier 25 Policy

APMA’s strong, sustained advocacy stopped a concerning Regence BlueShield Modifier 25 reimbursement policy from taking effect. After APMA raised significant concerns and actively pressed Regence to reconsider the change, Regence announced that it will not implement the policy, which had been scheduled to take effect September 1. 

 

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VA Clarification for Podiatric Physicians

APMA recently sought clarification from the Department of Veterans Affairs (VA) regarding how its revised Community Provider Standard for Orthotic, Prosthetic, and Pedorthic Devices (OPPD) applies to podiatric physicians.

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Proposed Modifier 25 Cuts

Today, APMA President Patrick DeHeer, DPM; APMA CEO Meghan McClelland; and members of the APMA advocacy team met directly with Centers for Medicare & Medicaid Services (CMS) officials to urge the agency to withdraw its proposed 50 percent payment cut for certain same-day services reported with Modifier 25.

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On-Call Compensation Resources

In a new short video, Danielle Butto, DPM, shares national data on on-call compensation for podiatric physicians and lessons from her own experience successfully advocating for compensation. She discusses the importance of collecting hospital-specific data, demonstrating the value DPMs bring to their hospitals, working together with colleagues, and approaching negotiations strategically. 

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APM Incentive Payments and MIPS Final Scores

CMS recently shared two updates related to Quality Payment Program participation.

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Modifier 25 Payment Cuts

CMS recently published the proposed rule for the Calendar Year (CY) 2027 MPFS, which includes an arbitrary 50 percent payment reduction for services reported on the same day with Modifier 25. APMA strongly opposes this policy, which would unfairly penalize physicians for providing necessary, distinct care during a single patient visit and could create new barriers to efficient, timely care.

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Payment Reform

As part of APMA’s ongoing collaboration with both the GOP Doctors Caucus and Democratic Doctors Caucus on Medicare physician payment reform, APMA recently submitted comments in response to the caucuses’ request for information on HR 9693, the Patients First Act.

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Opposing Modifier 25 Cuts

 APMA and other medical specialty societies have formed the Same Day Care Coalition, to oppose cuts to Modifier 25 cuts. In addition, APMA is meeting with congressional podiatry champions and reaching out to Trump Administration officials.

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Medicare Adds Four DMEPOS Items

Effective October 28, Medicare will add four items to the Master List that may be relevant to podiatric physicians. Inclusion on the Master List does not mean an item requires prior authorization. Rather, items on the Master List have been identified by Medicare as potentially susceptible to fraud or unnecessary utilization and may be subject to additional conditions of payment.

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Topical Oxygen LCD

Last week, the DME MACs released a proposed LCD for treating non-healing diabetic foot ulcers with topical oxygen. The proposed LCD outlines coverage criteria required to initiate therapy and another set of criteria required to continue therapy beyond one month. This proposed LCD is now in a comment period, and APMA will be submitting comments on behalf of its members.

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For Podiatrists

No matter where you are on your podiatry journey, APMA has the tools and resources you need to grow your career.

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For Patients

Your feet are your foundation for a healthy and happy life. Learn more about conditions affecting the feet and ankle, and when you need to see a podiatrist.

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APMA Member Top Resources

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Coding Resources

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-59 Modifier Tool Kit

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Private Insurance Resource Guide

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Young Physician Transition Series

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Dean’s Chat

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Online CECH

For Students

Educational Resources for Students

Check out resources to guide you through podiatric medical school and into residency.

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Podiatric medical students receive complimentary membership to APMA. Activate yours today.

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Student Resources

Find the help you need for the first step of your foot and ankle career.

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JAPMA

JAPMA is the preeminent and award-winning scientific journal for America's foot and ankle physicians and surgeons.

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