Saturday, July 25, 2026

The American Academy of Sleep Medicine published its analysis of the 2027 Physician Fee Schedule proposed rule. The AASM confirms the inclusion of three new CPT codes for Type IV home sleep apnea testing (unattended sleep studies) and notes valuation cuts to several other sleep medicine services as part of the budget-neutrality adjustment. The group is preparing comments to CMS ahead of the September 2026 deadline. For sleep medicine and pulmonary practices, this means the proposed rule solidifies the transition of certain home sleep testing to specific new codes for 2027. Monitor the AASM's final comments and prepare to update your chargemasters and billing systems for the new Type IV CPT codes (expected to be 958XX series) if finalized.

The American College of Radiology released its impact tables analyzing the 2027 Medicare Physician Fee Schedule proposed rule. The tables show the projected effect on total allowed charges by specialty, reflecting the combined impact of the proposed 2.26% conversion factor cut, work RVU changes, and practice expense updates. Radiology, along with other procedure-heavy specialties, faces a net negative impact under the proposal. This granular analysis allows radiology groups to model their specific Medicare revenue risk for 2027. The ACR will use this data in its formal comments to CMS. Radiologists and billing managers should review the ACR's tables to understand the magnitude of the proposed cuts and begin budget projections for the 2027 calendar year.

Idaho officials confirm the state's strict Medicaid work requirements will take effect next year. The rules, which require most able-bodied adults without dependents to work, volunteer, or participate in job training for at least 80 hours per month, are among the most stringent in the nation. State officials assert that most current beneficiaries already meet the requirements, but the policy shift will necessitate new administrative processes for enrollment, verification, and reporting. For clinics, this means eligibility checks for Idaho Medicaid patients will become more complex starting in 2027, with potential for coverage interruptions and increased administrative burden. Monitor Idaho's Department of Health and Welfare for implementation details and verification portal updates over the next six months.