Mandatory ambulatory specialty model will play in Peoria, along with 234 other areas

Physicians who meet the basic requirements for participation in Medicare's new, mandatory value-based care program take note: CMS took another step toward implementing the ambulatory specialty model (ASM), which will begin Jan. 1, 2027 (PBN 11/17/25, subscription required). The agency issued the list of the program's "mandatory geographic areas," on Dec. 23, 2025. 

 

In the final 2026 Medicare physician fee schedule, CMS said that it would launch the program in randomly selected core-based statistical areas (CBSA) and metropolitan divisions and that it would release the list of areas at a later date. 

 

If you check the spreadsheet that CMS provided, be aware that each named region represents at least one county, not the city or cities listed in the region name. For example, “Peoria, IL” represents Peoria county, which includes Peoria, Elmwood and Chillicothe, Ill. “Aberdeen, SD,” represents two counties and “Arlington-Alexandria-Reston, VA-WV,” represents 12 counties and six independent cities.

 

Based on a Part B News review of the list, only three states, Maine, Nevada and Wyoming, were not included, but physicians should watch for more information from CMS. The agency will release an initial list of participating physicians early in 2026 and a final list "during CY 2026 to give specialists time to prepare," according to a frequently asked question about the program.