The Centers for Medicare and Medicaid Services (CMS) has published the final participant list for the upcoming mandatory Ambulatory Specialty Model (ASM) for heart failure (HF) and low back pain starting in January 2027. The final list includes over 5,550 clinicians with 2,215 in the HF cohort – 395 fewer than the initial preliminary list from February 2026. Consistent with the agency’s earlier statements, CMS did not add any new participants beyond those identified in the preliminary list.

Based on ACC’s review of the preliminary and final list of participants, numerous physicians with specialties other than cardiovascular disease, like electrophysiology, interventional cardiology and advanced HF and transplant, remain on the list. As part of the 2027 Medicare Physician Fee Schedule (PFS) proposed rule, CMS proposed an exception process for HF specialty changes. Once finalized, incorrectly selected participants will be able to submit the applicable specialty documentation to CMS for removal from the ASM program. The ACC will share instructions for the exception process as soon as they are available.

Last week, the ACC submitted public Medicare PFS comments regarding the ASM participation selection process as well as member feedback on the model’s overall design, bonus and penalty structure, and operational uncertainty to participate in the ASM. Those comments amplify the substance of past and ongoing discussions between the ACC and key Center for Medicare and Medicaid Innovation and CMS staff.

Clinical Topics: Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Centers for Medicare and Medicaid Services, U.S., ACC Advocacy, Heart Failure, Cardiologists, Costs and Cost Analysis, Decision Making, Workforce, Patient Care, Policy