Disclaimer: CMS has proposed adjustments to the Ambulatory Specialty Model in the Medicare Physician Fee Schedule proposed rule. This page will be updated in November when CMS finalizes its ASM policies. Contents of these pages reflect current ASM policies as finalized in November 2025.
In 2025, the Centers for Medicare and Medicaid Services (CMS) finalized the Ambulatory Specialty Model (ASM), a new mandatory CMS Innovation Center model that will require many PM&R, pain management, and interventional pain management specialists to participate. Starting in 2027, the model will hold certain specialists accountable for quality and cost metrics related to low back pain. Performance on these measures will be used to adjust Medicare Part B payments.
This resource provides background on the model and key considerations for PM&R physicians as they prepare for ASM. AAPM&R is also continuing to actively engage with CMS to refine the model to address operational challenges and ensure it provides meaningful value to PM&R physicians.