Effective date
Medicare changes effective January 1, 2026
25 CMS and MAC policy updates take effect on this date across 4 MAC jurisdictions. Every entry links to the government document it came from.
CMS Coverage API · 11
- LCD L39391: Vitamin D Assay Testing — Palmetto GBA
LCD-L39391Palmetto GBAClinical Laboratorysource ↗
- LCD L37602: MDS FISH — Palmetto GBA
LCD-L37602Palmetto GBAClinical Laboratorysource ↗
- LCD L35490: Category III Codes — WPS
LCD-L35490WPSMulti-specialtysource ↗
- LCD L35755: Non-Invasive Abdominal / Visceral Vascular Studies — WPS
LCD-L35755WPSRadiologysource ↗
- LCD L33826: Oral Anticancer Drugs — DME MAC
LCD-L33826DME MACOncologysource ↗
- LCD L33824: Immunosuppressive Drugs — DME MAC
LCD-L33824DME MACDMEsource ↗
- LCD L34648: Bisphosphonate Drug Therapy — WPS
LCD-L34648WPSOncologysource ↗
- LCD L34528: Blepharoplasty, Blepharoptosis and Brow Lift — WPS
LCD-L34528WPSOphthalmologysource ↗
- LCD L37011: ProMark® Risk Score — WPS
LCD-L37011WPSOutpatientsource ↗
- LCD L34623: Intraoperative Neurophysiological Testing — WPS
LCD-L34623WPSNeurologysource ↗
- LCD L33827: Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) — DME MAC
LCD-L33827DME MACDMEsource ↗
federal_regulatory · 8
- 2026 Inpatient Prospective Payment (IPPS)
INPATIENT-PROSPECTIVE-PAYMENT-IPPS-2026NationalInpatient (IPPS)source ↗
- 2026 ESRD Prospective Payment System
ESRD-PROSPECTIVE-PAYMENT-SYSTEM-2026NationalESRDsource ↗
- 2026 Physician Fee Schedule (PFS)
PHYSICIAN-FEE-SCHEDULE-PFS-2026NationalPhysician Fee Schedulesource ↗
- 2026 Skilled Nursing Facility PPS
SKILLED-NURSING-FACILITY-PPS-2026NationalSkilled Nursing Facilitysource ↗
- 2026 DMEPOS Fee Schedule
DMEPOS-FEE-SCHEDULE-2026NationalDMEsource ↗
- 2026 Clinical Laboratory Fee Schedule
CLINICAL-LABORATORY-FEE-SCHEDULE-2026NationalClinical Laboratorysource ↗
- 2026 Home Health Prospective Payment
HOME-HEALTH-PROSPECTIVE-PAYMENT-2026NationalHome Healthsource ↗
- 2026 Ambulance Fee Schedule
AMBULANCE-FEE-SCHEDULE-2026NationalAmbulancesource ↗
Federal Register · 6
- Federal Register Final Rule: Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, and End-Stage Renal Disease Treatment Choices Model
FR-2025-20681NationalESRDsource ↗
- Federal Register Notice: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
FR-2025-12195NationalMulti-specialtysource ↗
- Federal Register Notice: Medicare Program; CY 2026 Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts
FR-2025-20249NationalInpatient (IPPS)source ↗
- Federal Register Final Rule: Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
FR-2025-19787NationalPhysician Fee Schedulesource ↗
- Federal Register Final Rule: Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies
FR-2025-21767NationalHome Healthsource ↗
- Federal Register Final Rule: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating; Hospital Price Transparency; and Notice of Closure of a Teaching Hospital and Opportunity To Apply for Available Slots
FR-2025-20907NationalHospital Outpatient (OPPS)source ↗