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8 updates tracked

Medicare Legislative Updates for Providers

CMS regulatory changes, final rules, coverage expansions, and billing updates that affect PT, OT, ST, ABA, EMS, DME, and mental health providers in 2026.

Action required ABA
ABA Therapy Medicare Coverage 2026: What Providers Need to Do Now
ABA therapy is now covered under Medicare Part B. Here is what BCBAs and BCaBAs need to do to enroll and start billing — and the risks to avoid.
June 2026
Effective Jan 2026
Action required Mental Health LMHC
LMHCs Are Now Medicare-Approved: Enrollment Checklist
Licensed Mental Health Counselors are now eligible for Medicare enrollment. Here is the enrollment checklist, required forms
May 2026
Effective Jan 2026
Action required EMS
EMS Medicare Billing Changes: What Providers Need to Know (2026)
Ground ambulance and EMS Medicare billing changes effective 2026 — prior authorization expansion, non-emergency transport documentation
April 2026
Action required All providers
Medicare Prior Authorization Rule Changes — What Providers Need to Know
CMS expanded prior authorization requirements for selected outpatient services. Here is which services are affected, how to submit requests
March 2026
Update All providers ABA Mental Health
PECOS Enrollment Updates 2026: New Provider Types, Faster Processing, and What Changed
CMS updated PECOS in 2026 to support new provider types including BCBAs and LMHCs, reduce paper-based processing, and improve revalidation workflows. Here is what changed.
February 2026
Effective Jan 2026
Update All providers PT OT
CY2026 Medicare Physician Fee Schedule: Key Changes for Allied Health and Specialty Providers
The CY2026 PFS final rule cut the conversion factor and made significant changes to telehealth, behavioral health, and therapy billing. Here is what providers need to know.
January 2026
Effective Jan 2026
Update PT OT SLP
KX Threshold CY2026: $2,480 Combined PT + SLP — What Changes
The CY2026 KX threshold is $2,480 combined for PT and SLP. Here is what triggers the exception, what documentation is required, and what changed from CY2025.
January 2026
Effective Jan 2026
Update All providers
MIPS and QPP Updates for 2026: Provider Checklist
CY2026 MIPS performance category weights, Promoting Interoperability requirements, small practice exemption thresholds
January 2026
M
What does this update mean for my practice?

Ask Mae your specialty and she'll translate the regulatory change into action steps for your enrollment or billing.