Who's in the Ambulatory Specialty Model
Every clinician CMS selected for the 2027 performance year: heart failure and low back pain specialists whose Medicare Part B payments will be adjusted up or down, starting in 2029, based on how they score against peers.
CMS final participant list, updated September 15, 2026 · Methods & sources
Where the participants practice
CMS selected clinicians practicing in specific metro areas (CBSAs). Tap a state to see its metro areas and specialties, then look up the clinicians.
Nationwide
Is a clinician or group in ASM?
Search the CMS list by name, NPI, organization, city or metro area.
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How much Part B payment is at risk
ASM multiplies each participant's Medicare Part B payments for covered professional services in a payment year by 1 + an adjustment between −risk level and roughly +risk level, set by their final score relative to peers in the same cohort.
cohort pool = 85% × risk level × payments (CMS keeps the other 15%)
Model maximum downside and any adjustment scenario for any state, specialty, cohort or organization, using each clinician's 2024 Medicare payments. Follows the lookup filters above.
The model in brief
ASM is a mandatory CMS Innovation Center model with five performance years (January 1, 2027 to December 31, 2031) and payment years 2029 to 2033. It replaces MIPS for participants and scores them on four categories: quality and cost (50% each), plus improvement activities and Promoting Interoperability, which subtract points when not met.
Who: cardiologists who treat heart failure, and anesthesiology, pain management, interventional pain management, neurosurgery, orthopedic surgery and physical medicine & rehabilitation specialists who treat low back pain, in selected metro areas, who treated at least 20 Original Medicare patients with the condition in a 12-month period.
Money: scores are compared within each cohort; a logistic exchange function centred on the cohort median turns scores into adjustments. The pool paid out equals 85% of the at-risk amount, so on average the cohort gives back 15% of it. Small practices (15 or fewer clinicians) get a scoring adjustment rather than a lower risk level.
How this is built
- Participants
- CMS, Ambulatory Specialty Model Participants (data.cms.gov dataset 175d576d-0568-4ac2-aec5-d77f3ee02205), CY2027 final list, modified 2026-09-15: 5,556 rows, 5,533 clinicians (23 appear under two organizations). Replaces the preliminary list this tool used before (6,631 rows, 6,504 clinicians).
- Payments
- CMS, Medicare Physician & Other Practitioners by Provider, data year 2024 (released May 2026). Base = Medicare payment for medical (non-drug) services, the closest public proxy for Part B covered professional services. For 786 clinicians CMS suppresses the drug split, so the total payment is used. Clinicians under two organizations have dollars split evenly across both rows. City in the lookup is the PUF practice city.
- Rules
- 42 CFR 512.750 (CY2026 Physician Fee Schedule final rule, 90 FR 49266, Nov 5, 2025; regulation text at 90 FR 50031; correction 91 FR 12071, Mar 12, 2026): risk levels 9% (2029), 9% (2030), 10% (2031), 11% (2032), 12% (2033); redistribution percentage 85%. CMS ASM page and fact sheet.
- Formulas
- Max downside = risk level × base. Scenario impact = chosen adjustment × base. Cohort pool = 0.85 × risk level × Σ base; expected net to the cohort = −0.15 × risk level × Σ base. Organization totals sum their rows.
- Limitations
- Payments are 2024 actuals, not the 2029–2033 payment years, and include all of a clinician's Part B professional services across every TIN they bill under. Actual adjustments depend on final scores and CMS's scaling factor; the maximum positive adjustment can exceed the risk level. Clinicians without a final score get no adjustment. The PUF omits Medicare Advantage.
- Last refreshed
- 2026-09-26. Scripts:
satellites/asm/scripts/in the Techy Surgeon repo; refresh when CMS updates the participant dataset or releases a new PUF year.
Disclosure: Christian Pean, MD, who publishes Techy Surgeon, is CEO of RevelAi Health, a health-technology company. An earlier version of this dashboard carried the RevelAi name; this version is rebuilt and maintained by Techy Surgeon.