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; Correction

DEPARTMENT OF HEALTH AND HUMAN SERVICES <SUBAGY>Centers for Medicare & Medicaid Services</SUBAGY> <CFR>42 CFR Parts 405, 410, 414, 424, 425, 427, 428, 495, and 512</CFR> <DEPDOC>[CMS-1832-CN]</DEPDOC> <RIN>RIN 0938-AV50</RIN> <SUBJECT>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; Correction</SUBJECT> <HD SOURCE="HED">AGENCY:</HD> Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS). <HD SOURCE="HED">ACTION:</HD> Proposed rule; correction. <SUM> <HD SOURCE="HED">SUMMARY:</HD> This document corrects typographical and technical errors in the proposed rule that appeared in the July 16, 2025 <E T="04">Federal Register</E> (90 FR 32352) titled “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” (hereinafter referred to as the CY 2026 PFS proposed rule), specifying proposed changes to the Medicare physician fee schedule (PFS) that is applicable for calendar year (CY) 2026, and other changes to Medicare Part B payment policies, as well as proposals regarding other Medicare payment policies. </SUM> <EFFDATE> <HD SOURCE="HED">DATES:</HD> To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on September 12, 2025. </EFFDATE> <HD SOURCE="HED">ADDRESSES:</HD> In commenting, please refer to file code CMS-1832-P. Comments, including mass comment submissions, must be submitted in one of the following three ways (please choose only one of the ways listed): 1. <E T="03">Electronically.</E> You may submit electronic comments on this regulation to <E T="03">http://www.regulations.gov.</E> Follow the “Submit a comment” instructions. 2. <E T="03">By regular mail.</E> You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1832-P, P.O. Box 8016, Baltimore, MD 21244-8016. Please allow sufficient time for mailed comments to be received before the close of the comment period. 3. <E T="03">By express or overnight mail.</E> You may send written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1832-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850. <FURINF> <HD SOURCE="HED">FOR FURTHER INFORMATION CONTACT:</HD> <E T="03">MedicarePhysicianFeeSchedule@cms.hhs.gov,</E> for any issues not identified below. Please indicate the specific issue in the subject line of the email. For all questions related to reporting a service on a claim, please contact your Medicare Administrative Contractor. Michael Soracoe, Morgan Kitzmiller, or <E T="03">MedicarePhysicianFeeSchedule@cms.hhs.gov,</E> for issues related to practice expense, work RVUs, conversion factor, and PFS specialty-specific impacts. Hannah Ahn, or <E T="03">MedicarePhysicianFeeSchedule@cms.hhs.gov,</E> for issues related to potentially misvalued services under the PFS. Pamela West, or <E T="03">MedicarePhysicianFeeSchedule@cms.hhs.gov,</E> for issues related to outpatient therapy services and KX modifier thresholds. Janae James, (410) 786-0801, or <E T="03">SharedSavingsProgram@cms.hhs.gov,</E> for issues related to the Medicare Shared Savings Program. Amy Gruber, (410) 786-1542, for issues related to Ambulance Extender provisions. Kati Moore, (410) 786-5471, for inquiries related to the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program (QPP). Trevey Davis, (667) 290-8527, for inquiries related to the Advanced Alternative Payment Models (APMs) track of QPP. Laura Kennedy, (410) 786-3377, Rebecca Ray, (667) 414-0879, and Jae Ryu, (667) 414-0765 for issues related to Drugs and Biological Products Paid Under Medicare Part B. </FURINF> <SUPLINF> <HD SOURCE="HED">SUPPLEMENTARY INFORMATION:</HD> <HD SOURCE="HD1">I. Background</HD> In FR Doc. 2025-13271 of July 16, 2025, the CY 2026 PFS proposed rule (90 FR 32352), there were typographical and technical errors that are identified and corrected in this correcting document. <HD SOURCE="HD1">II. Summary of Errors</HD> <HD SOURCE="HD2">A. Summary of Errors in the Preamble</HD> On page 32352, we inadvertently made a typographical error. On page 32353, we inadvertently included an incorrect Summary of the Key Provisions. On page 32386, we inadvertently omitted a potentially misvalued code nomination. On page 32503, we inadvertently omitted the section titled Outpatient Therapy Services and KX Modifier Thresholds from the proposed rule. On page 32637, we inadvertently included language related to the transfer of labeler codes. On page 32671, we inadvertently included an incorrect reference in footnote 323. On page 32717, we inadvertently made a technical error in the number of proposed substantive changes. On page 32770, we inadvertently included an incomplete sentence. On page 32771, we inadvertently included a typographical error. On page 32776, we inadvertently made a technical error in a table reference. On page 32777, we inadvertently included language that reflected the standard non-rule PRA process. On page 32778, we made an inadvertent typographical error in a section reference. On page 32779, we inadvertently made a typographical error. On page 32781, we inadvertently omitted text preceding table `Table 82: TABLE 82: Annual Responses Beginning with the CY 2027 Performance Period/2029 MIPS Payment Year Under OMB Control Number 0938-1222 (CMS-10450). On page 32793, we inadvertently referenced a regulatory citation and made technical errors in Table 87: Proposed Annual Requirements and Burden Estimates. On page 32799, we inadvertently made two typographical errors. On page 32801, in Tables 89, 90, and 91, the CY 2026 RVU Budget Neutrality Adjustment we inadvertently made typographical errors in the conversion factors. On page 32818, we made an inadvertent typographical error in a section reference. On page 32834, we inadvertently omitted a section heading. <HD SOURCE="HD2">B. Summary of Errors in the Regulations Text</HD> On page 32850, we inadvertently omitted regulation text changes to a definition in § 414.1305 and made formatting and paragraph designation errors in § 414.1380. On page 32851, we made technical errors in § 414.1400(d)(3)(vi)(A). <HD SOURCE="HD2">C. Summary of Errors in Appendices</HD> On page 33162, under Table DD.2 Colorectal Cancer Screening, we inadvertently made a typographical error in the Substantive Change row. On page 33183, we inadvertently made a typographical error in omitting the asterisk (*) key after “Symbol Key:” On page 33208 in Table B.2, we inadvertently omitted quality measure Q144: Oncology: Medical and Radiation, Plan of Care for Pain under the Advancing Cancer Care MVP, the Radiation Oncology Clinical Grouping. On page 33219, we made inadvertent errors in the list of Improvement Activities included in the Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes MVP. On page 33255, we inadvertently repeated several paragraphs. <HD SOURCE="HD1">III. Waiver of the 60-Day Public Comment Period</HD> Under section 553(b) of the Administrative Procedure Act (the APA) (5 U.S.C. 553(b)), the agency is required to publish a notice of proposed rulemaking in the <E T="04">Federal Register</E> before the provisions of a rule take effect. Similarly, section 1871(b)(1) of the Social Security Act (the Act) requires the Secretary to provide for notice of the proposed rule in the <E T="04">Federal Register</E> and provide a period of not less than 60 days for public comment. Section 553(b)(B) of the APA provides for exceptions from the APA notice and comment requirements; in cases in which these exceptions apply, section 1871(b)(2)(C) of the Act provides exceptions from the notice and 60-day comment period requirements of the Act as well. Section 553(b)(B) of the APA and section 1871(b)(2)(C) of the Act authorize an agency to dispense with normal notice and comment rulemaking procedures for good cause if the agency makes a finding that the notice and comment process is impracticable, unnecessary, or contrary to the public interest, and includes a statement of the finding and the reasons for it in the rule. In our view, this correcting document does not constitute a rulemaking that would be subject to these requirements. The corrections made through this correcting document are intended to resolve inadvertent errors so that the CY 2026 PFS proposed rule accurately reflects the policies proposed therein. In addition, even if this were a rulemaking to which the notice and comment requirements applied, we find that there is good cause to waive such requirements. The 60-day comment period referenced in section 1871(b)(1) of the Act may be shortened, as provided under section 1871(b)(2)(C) of the Act, when the Secretary finds good cause that a 60-day comment period would be impracticable, unnecessary, or contrary to the public interest and incorporates a statement of the finding and its reasons in the rule issued. For this proposed rule correcting document, we are waiving the 60-day comment period for good cause and allowing a comment period that coincides with the comment period provided for the CY 2026 PFS proposed rule. Undertaking further notice and comment procedures to incorporate the corrections in this document into the CY 2026 PFS proposed rule would ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Preview showing 10k of 36k characters. Full document text is stored and available for version comparison. ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━