Advocacy is one of the three pillars of ASRA Pain Medicine's mission. ASRA Pain Medicine addresses this core purpose by advocating at the regulatory level in the best interest of our members and the patients they serve. (Note: ASRA Pain Medicine does not participate in political advocacy.)
The Latest Health Policy Updates
CMS Releases CY 2026 Proposed Medicare Payment Rules
On July 16, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Medicare Physician Fee Schedule Proposed Rule. For the first time in five years, CMS proposes a positive update to the Medicare conversion factor (CF)—the base dollar amount used to calculate payments for physician services.
Two separate CFs are proposed for 2026, as required by the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act (MACRA):
- $33.5875 for clinicians who qualify under Advanced Payment Models (APMs), reflecting a 0.75% statutory increase.
- $33.4209 for all other clinicians, reflecting a 0.25% statutory increase.
These updates result from a 2.5% increase enacted in recent legislation and a 0.55% budget neutrality adjustment. However, CMS also proposes a 2.5% efficiency adjustment that would reduce work relative value units (RVUs) for non-time-based services.
The agency states that as clinicians gain experience, certain procedures take less time and intensity and should be reimbursed accordingly. The adjustment is based on a five-year Medicare Economic Index productivity review and would be recalculated every three years. Evaluation and management (E/M) services would be excluded from this policy.
ASRA Pain Medicine is reviewing the proposed rule and will submit formal comments by the September 12, 2025, deadline.
In parallel, CMS released details of a proposed “Ambulatory Specialty Model” for lower back pain and congestive heart failure. This model would assess performance across quality, cost, care improvement activities, and improved interoperability. Its goal is to reward individual providers who do things like encourage lifestyle changes, detect risk and signs of chronic conditions early, and reduce avoidable hospitalizations. If finalized, it would begin in 2027 and run for five performance years through December 31, 3031.
View CMS’s fact sheet and press release for further details.
Read More
CMS Releases CY 2026 Proposed Medicare Payment Rules
On July 16, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Medicare Physician Fee Schedule Proposed Rule. For the first time in five years, CMS proposes a positive update to the Medicare conversion factor (CF)—the base dollar amount used to calculate payments for physician services.
Two separate CFs are proposed for 2026, as required by the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act (MACRA):
- $33.5875 for clinicians who qualify under Advanced Payment Models (APMs), reflecting a 0.75% statutory increase.
- $33.4209 for all other clinicians, reflecting a 0.25% statutory increase.
These updates result from a 2.5% increase enacted in recent legislation and a 0.55% budget neutrality adjustment. However, CMS also proposes a 2.5% efficiency adjustment that would reduce work relative value units (RVUs) for non-time-based services.
The agency states that as clinicians gain experience, certain procedures take less time and intensity and should be reimbursed accordingly. The adjustment is based on a five-year Medicare Economic Index productivity review and would be recalculated every three years. Evaluation and management (E/M) services would be excluded from this policy.
ASRA Pain Medicine is reviewing the proposed rule and will submit formal comments by the September 12, 2025, deadline.
In parallel, CMS released details of a proposed “Ambulatory Specialty Model” for lower back pain and congestive heart failure. This model would assess performance across quality, cost, care improvement activities, and improved interoperability. Its goal is to reward individual providers who do things like encourage lifestyle changes, detect risk and signs of chronic conditions early, and reduce avoidable hospitalizations. If finalized, it would begin in 2027 and run for five performance years through December 31, 3031.
View CMS’s fact sheet and press release for further details.
Pain Medicine Coalition
ASRA Pain Medicine and the American Society of Anesthesiologists (ASA) established the Pain Medicine Coalition (PMC) in 2024 to advance the common goals of the pain medicine community and to advocate for responsible pain care for all patients. The International Pain & Spine Intervention Society (IPSIS) and the American Academy of Physical Medicine and Rehabilitation (AAPM&R) are also members of the coalition. Its purpose is to develop, monitor, and advocate for responsible health care policy for people who experience both acute and chronic pain and the physicians who support them. They do their work through clinical care, education addressing quality of care, access to care, public and professional education, and research.
Read more about the Pain Medicine Coalition:
ASA and ASRA Pain Medicine: Speaking With One Voice
President’s Message: The Power of ASRA Pain Medicine Volunteers
Are You a Member of AMA?
The American Medical Association (AMA) is the nation's largest physician organization and works to advocate for key issues that matter in your practice such as prior authorization, Medicare reform, promoting physician-led work, and more. ASRA Pain Medicine works with the AMA to advocate for the issues that matter in your practice with representation in the AMA House of Delegates, the Relative Value Scale Update Committee, and the Current Procedural Terminology Committees. ASRA Pain Medicine provides expert information and testimony specific to regional anesthesia and acute and chronic pain.
Learn more about the benefits of membership in AMA.
Read the latest AMA news and sign up for news alerts at ama-assn.org.
Practice Management
Find more health policy information in our Practice Management Resource Center.