Despite multiple ACC requests for modifications or delay, the Centers for Medicare and Medicaid Services (CMS) declined to provide a transition or education period before implementation of the Ambulatory Specialty Model (ASM) for heart failure (HF). In the 2027 Medicare Physician Fee Schedule (PFS) final rule, released last week, CMS confirmed the model will begin its initial performance year on Jan. 1, 2027.

The agency also finalized several exception processes for selected ASM participants whose TIN or specialty designation changes during the model period. CMS removed proposed physician notification requirements for these exceptions, instead opting to regularly monitor claims data for TIN changes and PECOS enrollment information for specialty changes.

The current ASM participant list, published in September, includes approximately 400 ACC members who appear to be incorrectly designated as specializing in cardiovascular disease rather than their appropriate subspecialty. Only physicians with cardiovascular disease specialty designation are required to participate in ASM.

The ACC strongly encourages members to review their Medicare enrollment information and update their specialty designation and contact information if needed. For more information about ASM, including implementation guides, FAQs and presentation slides, visit ACC's ASM for HF webpage.

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

Keywords: ACC Advocacy, Centers for Medicare and Medicaid Services, U.S., Heart Failure, Fee Schedules, Cardiology