Time-sensitive: The final CMS ASM participant roster releases in July 2026, based on your 2025 claims. Check the CMS model page →
Ambulatory Specialty Model — Effective Jan 1, 2027
Your Medicare risk is now personal
CMS is moving value-based risk from institutions to individual surgeons. Starting 2027, your episode costs for low back pain will be scored against regional peers — and the bonus or penalty attaches to every Part B dollar you bill, not just back pain cases.
~8,600 physicians enrolled nationallyNo opt-out, no hardship exemptionFinal roster due July 2026
ASM Risk Profile
What the model actually does to your income
±9%
of all Part B payments, years 1–2
±12%
by performance year 5 (2031)
$2.8B
total annual episode spending in scope
+2 yrs
lag — adjustments hit in 2029
The adjustment is not ring-fenced to back pain work. It attaches to every Part B dollar the enrolled surgeon bills — orthopedic procedures, office visits, all of it.
Critical Dates
July 2026 — Final ASM roster published (based on 2025 claims)
Jan 1, 2027 — Performance year begins. No opt-out.
2029 — First payment adjustments land (±9% of Part B)
What Changed
Three structural shifts in how CMS scores surgeons
ASM is not another bundled payment pilot. It is the first mandatory APM built around specialists managing chronic conditions — and it changes the unit of accountability from hospital to individual NPI.
⚠
Individual NPI scoring
For two decades, hospital systems absorbed bundled payment risk and individual surgeons kept billing FFS. ASM removes that buffer. Your episode cost profile is yours alone — no institutional averaging.
No institutional buffer
↗
Risk follows you to your next job
A surgeon in penalty band carries that ASM exposure into any new employment arrangement. Practice administrators and PE groups evaluating a surgeon acquisition are now buying that surgeon's ASM standing.
Portable risk at hiring
◈
All Part B at risk — not just back pain
The ±9% corridor applies to your entire Medicare Part B payment stream. A spine surgeon billing $1.2M in Part B has up to $108,000 in penalty exposure that has nothing to do with how many fusions they did.
Full Part B at risk
Exposure Calculator
Estimate your ASM income at risk
Enter your annual Medicare Part B revenue. The model shows your potential penalty or bonus in the first performance corridor.
Your total Medicare Part B collections, all specialties — not just back pain
◈
Enter your Part B revenue and calculate to see your exposureHow SurgeonValue Helps
Six ASM-ready capabilities, active on day one
SurgeonValue was built around the core insight that Becker's named: "leaders best positioned for ASM already know their episode economics." These features make that true for you.
01
ASM Enrollment Check
On onboarding, we automatically check whether your NPI appears on the published CMS ASM participant list. Most affected surgeons don't know they're enrolled.
Free tier
02
Episode Cost Benchmarking
See your ASM-relevant cost profile against regional peers in real time — before CMS tells you post hoc. Know where you stand before the adjustment lands.
Standard
03
Confirmation Rate Trending
Wonder Bill's confirmation loop tracks which CPT codes your documentation supports versus what you're billing — the foundation of drift monitoring.
Standard
04
Payer Policy Changelog
When payer policy changes, your exposure changes. We decouple payer policy updates from AI model retraining so your billing logic stays current.
Standard
05
Portable NPI Report
A one-page ASM standing report for practice administrators and PE groups evaluating surgeon acquisitions. Your ASM score is now a financial variable at hiring time.
Standard
06
Prior Auth — 60 seconds
Auth delays extend episodes and blow your target. The Prior Auth agent drafts appeal letters in 60 seconds, citing the exact policy language that governs denial.
All tiers
“
The leaders best positioned for ASM tend to share one trait: They already know their own episode economics before a payer, employer or government model tells them what those economics should be.
Becker's Spine Review · June 2026
Get Started
Know your episode economics before CMS does
The ASM enrollment check is free. Episode cost benchmarking and the full ASM compliance dashboard are available on Standard.
Free
Free forever
$0/mo
Wonder Bill + ASM enrollment check. No credit card.
- ✓ Wonder Bill — paste one note, find missed CPT codes
- ✓ ASM enrollment check by NPI
- ✓ Prior auth drafts (3/mo)
- ✓ HIPAA compliant
Most popular
Standard
$199/mo
Full ASM compliance dashboard + all 11 agents.
- ✓ Everything in Free
- ✓ Episode cost benchmarking vs. regional peers
- ✓ Confirmation rate trending by CPT family
- ✓ Payer policy changelog (AI-decoupled)
- ✓ Portable NPI risk report
- ✓ Unlimited prior auth drafts
- ✓ RTM / CCM enrollment tracking