On Sept. 16, the Centers for Medicare & Medicaid Services (CMS) announced the following Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) updates. An MVP is a reporting option that allows clinicians to report on a smaller, specialty-focused set of quality measures and [...]
The American Academy of Sleep Medicine (AASM) recently submitted comments on the Centers for Medicare & Medicaid Services (CMS) 2027 Medicare Physician Fee Schedule (PFS) proposed rule. The letter outlines the Academy's recommendations on policies that could significantly affect sleep medicine practices, patient access [...]
On July 14, the Centers for Medicare & Medicaid Services released the 2027 Medicare Physician Fee Schedule (PFS) proposed rule, which includes potential revisions to the quality payment program. Highlights of the proposed revisions that may affect sleep medicine professionals include: CMS is proposing to phase out the traditional Merit-based Incentive Payment System (MIPS) reporting option after the CY 2028 performance period. Beginning [...]
On July 14, the Centers for Medicare & Medicaid Services (CMS) released the 2027 physician fee schedule (PFS) proposed rule. The proposal includes payment updates, telehealth policies, and several initiatives that could affect sleep medicine physicians and accredited sleep centers beginning Jan. 1, [...]
The Centers for Medicare & Medicaid Services continues to emphasize changes to the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) accreditation process to strengthen oversight of DMEPOS suppliers and ensure ongoing compliance with Medicare supplier standards. These changes took effect Jan. 1, [...]
DARIEN, IL — New Current Procedural Terminology codes for unattended sleep testing have been included by the Centers for Medicare and Medicaid Services in the Medicare physician fee schedule proposed rule, which CMS posted online yesterday. The updated CPT code set, which the [...]
Recent physician payment debate in Congress Over the past several years, physician payment has remained one of the most urgent health policy issues before Congress. For sleep physicians, Medicare payment policy directly affects practice stability, access to care, and the ability to provide [...]
On April 14, 2026, the Centers for Medicare & Medicaid Services (CMS) published the Interoperability Standards and Prior Authorization for Drugs Proposed Rule, representing a significant step toward modernizing prior authorization processes and expanding interoperability across the healthcare system. These efforts directly affect sleep [...]
A new legislative proposal was submitted to the U.S. Senate Finance Committee and the Centers for Medicare & Medicaid Services by the American Medical Association to reform the current Merit-based Incentive Payment System (MIPS) and transition to a redesigned program called the Data-Driven [...]
States and professional organizations are increasingly challenging private insurers' downcoding of evaluation and management (E/M) services, a practice clinicians say undermines physician judgment and delays appropriate reimbursement. E/M downcoding occurs when payers automatically reduce the level of a clinician-reported E/M code, resulting in [...]