CMS Archives

RPM/RTM Reimbursement Rules Could Change in 2027

By Michael Shaughnessy

In CMS

Aug 21st, 2026

No Comments

On July 16, 2026, the Centers for Medicare & Medicaid Services (CMS) published its calendar year (CY) 2027 Medicare Physician Fee Schedule (MPFS) proposed rule in the Federal Register. Among the 716 pages are significant proposed changes to remote patient monitoring policies. Revenue Cycle Insider examined the remote monitoring policy changes CMS is proposing for ...

2027 Medicare PFS Proposed Rule: Key Payment and Coding Updates

By Renee Dustman

In Billing

Jul 15th, 2026

1 Comment

The calendar year (CY) 2027 Medicare Physician Fee Schedule (MPFS) proposed rule was published in the July 14 Federal Register for public inspection. Here are the highlights. Medicare Payment The CY 2027 payment updates for qualifying and non-qualifying Alternative Payment Model (APM) participants are unchanged, but the conversion factors are reduced: From CY 2026, these ...

Rethinking Coding and Documentation in a Value-Based Care Environment

By Dawn Carter

In CMS

Jul 1st, 2026

2 Comments

How the Clover Effect is changing how we approach Star Ratings and quality measurement. The Medicare Advantage (MA) Star Ratings program has long served as both a quality benchmark and a financial engine for health plans. That foundation was shaken in May 2026 when a federal court ruled in favor of Clover Health, finding that ...

A Change Is Coming for Billing Distant Site Telehealth Services

By Lee Fifield

In CMS

Jun 11th, 2026

No Comments

Billing rules for rural health clinics and federally qualified health centers will change in October. The Centers for Medicare & Medicaid Services (CMS) has released a change to its rules on the billing of distant site telehealth services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Starting Oct. 1, 2026, RHCs and ...

CMS to Provide $50 Monthly Access to Certain GLP-1 Medications

By Lee Fifield

In CMS

May 28th, 2026

No Comments

Medicare Part D recipients will soon receive help paying for their weight-loss treatments. The Centers for Medicare & Medicaid Services (CMS) will soon provide eligible individuals enrolled in Medicare Part D prescription drug plans access to certain GLP-1 medications for $50 per month beginning July 1, 2026, through Dec. 31, 2027. This Medicare GLP-1 Bridge, ...