CMS: Medicare and Medicaid Programs: CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program

Federal Register

Jul 15, 2025

Notice of a proposed rule from the Centers for Medicare & Medicaid Services (CMS) addressing: 1) changes to the Physician Fee Schedule and Medicare Part B payment policies; 2) policies for the Medicare Prescription Drug Inflation Rebate Program under the Inflation Reduction Act of 2022; 3) the Ambulatory Specialty Model; 4) updates to the Medicare Diabetes Prevention Program expanded model; 5) updates to drugs and biological products paid under Part B; 6) Medicare Shared Savings Program requirements; 7) updates to the Quality Payment Program; 8) updates to policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs); 9) updates to the Ambulance Fee Schedule regulations; 10) codification of the Inflation Reduction Act and Consolidated Appropriations Act, 2023 provisions; and 11) updates to the Medicare Promoting Interoperability Program. Comments are due on September 12, 2025.

Diabetes · Emergency medical services · Federally Qualified Health Centers · Healthcare quality · Legislation and regulations · Medicare · Pharmacy and prescription drugs · Reimbursement and payment models · Rural Health Clinics