The CMS Ambulatory Specialty Model (ASM) 2027 is mandatory for eligible specialists who treat Medicare patients for heart failure or low back pain. It starts January 1, 2027, and can raise or lower Medicare Part B payments based on performance. P3Care is an ASM reporting company in the USA. We provide ASM reporting support services that help your practice meet CMS ASM 2027 requirements.
ASM is a five-year program from the CMS Innovation Center. It runs from 2027 to 2031. Payments change two years after each performance year, so your 2027 results affect your 2029 payments.
You are eligible if you meet all four conditions:
ASM covers two conditions:
Each clinician is assessed by their own TIN and NPI, so two clinicians in the same group can have different results.
P3Care supports your practice from the first eligibility check through final CMS submission.
We match each clinician’s TIN and NPI against the CMS participant dataset. We then confirm specialty in CMS enrollment records (PECOS), because specialty determines cohort. Clinicians close to the 20-episode threshold are flagged early. You receive a clear list of who is in scope, who must report, and what each clinician needs to do next.
ASM assigns a fixed set of quality measures to each cohort, so every required measure needs a reliable data source. We map each measure to your electronic health record (EHR), import and validate the data, and prepare your submission before the deadline. We check each measure against current CMS specifications. Your team receives a simple checklist for each reporting period.
Patient-reported functional status is one of the most demanding measures in the low back pain cohort. We set up baseline and follow-up workflows, schedule reassessments, and track completion rates from the first month. Your staff receives simple prompts at check-in and at each visit. A measure that is not captured cannot be scored, so completion comes first.
ASM requires structured collaborative care arrangements with primary care partners. We help you draft, document, and maintain these arrangements, and we map the referral pathway and information sharing each one requires. Each arrangement is tracked against its required elements so gaps are visible early. We recommend that healthcare regulatory counsel review every arrangement before it is signed.
ASM scores improvement activities, including health-related social needs screening. We set up a screening tool, a workflow for your staff, and a structured field that stores each result. We also confirm that your EHR uses certified electronic health record technology (CEHRT) and organize the attestations for promoting interoperability. Missing an attestation can lower your score, so we track every deadline.
Cost makes up half of your score. We review your episode-based cost feedback and identify the services driving your spending. We flag episodes where more than one clinician in your group is attributed, because each attributed clinician carries the full episode cost. Clinical decisions remain with your physicians. Your team gets clear next steps for each finding.
We estimate what each clinician’s potential payment change could mean in dollars, based on total Medicare Part B professional payments. The estimate shows the effect of a 9% and a 12% adjustment, so leadership can compare readiness work with the revenue at stake. Results update as your data and CMS rules change. Figures help you decide where to invest first.
Your practice gets a named contact and a monthly performance review. We alert you early when completion rates fall, episode costs rise, or attribution changes, so you can act in time. We train clinicians and staff on ASM requirements before 2027 and refresh that training each year. We keep your documentation and submission calendar on track through every deadline.
Our ASM reporting services for cardiology practices cover heart failure quality measures, cost review for heart failure episodes, and help with EHR requirements. We work with your cardiologists to set up workflows, so your data is ready before each deadline. We review the measure set with your team at the start of each reporting year.
Our ASM reporting services for pain management specialists cover functional status tracking, review of the imaging, injections, and procedures that drive episode costs, and year-round monitoring for every low back pain clinician in your group. Interventional pain, neurosurgery, orthopedic surgery, and physical medicine and rehabilitation teams receive the same support.
A single coding error or missing claim can change who is attributed to an episode and how that episode appears in your data. P3Care reviews your claims and coding alongside your ASM reporting, so we catch problems during the performance year, when they can still be corrected.
Talk to a P3Care ASM specialist about your clinicians, claims, and reporting options.
Contact us for ASM Support
Does ASM change coverage or prior authorization rules?
No. ASM changes how Medicare adjusts payments based on performance. It does not change coverage determinations, coding rules, or prior authorization requirements.
What is ASM reporting?
ASM reporting is the process of collecting, checking, and submitting the quality data that CMS uses to score eligible clinicians under the Ambulatory Specialty Model.
How is ASM different from MIPS?
ASM uses a fixed set of measures for each condition, so you cannot pick your own the way you can under MIPS. If you are in ASM, you are exempt from MIPS for that performance year.
Are 20 patients the same as 20 episodes?
No. ASM counts attributed episodes, which come from claims and attribution rules. A patient list does not show your official volume, so we review your episode data to confirm it.
Can small practices report at the group level?
Yes. Practices with 15 or fewer clinicians can report quality at the TIN level. CMS may change this approach, so we confirm the method for each performance year.
Does ASM change coverage or prior authorization?
No. ASM changes how Medicare adjusts your payments based on performance. It does not change coverage rules, coding rules, or prior authorization
Is P3Care a CMS-qualified registry for ASM reporting?
Yes, P3Care is a CMS-qualified registry, so we can submit your ASM quality data directly.
