As the healthcare landscape continues to evolve, Medicare’s annual updates to its payment and documentation requirements bring both challenges and opportunities for podiatry practices. For calendar year (CY) 2026, the Centers for Medicare & Medicaid Services (CMS) finalized a set of changes to the Medicare Physician Fee Schedule (MPFS) that will directly affect documentation, billing accuracy, and reimbursement outcomes.

At JARALL Medical Management, we help podiatry practices navigate these changes with confidence. Below, we break down what’s changing, why it matters, and how practices can protect revenue while staying compliant.

Increased Documentation Scrutiny in Podiatry

Documentation deficiencies continue to be one of the most common reasons for Medicare denials in podiatry billing. Medicare audits consistently reveal that missing or unclear documentation accounts for a majority of improper payments related to podiatric services.

In 2026, Medicare is placing even greater emphasis on detailed clinical documentation that clearly demonstrates medical necessity. For podiatry practices, this means:

  • • Clear linkage between diagnosis and treatment
  • • Thorough progress notes supporting the level of care billed
  • • Consistent documentation of systemic conditions such as diabetes or neuropathy
  • • Detailed justification for routine foot care services

Skin Substitute Payment Changes and Incident-To Requirements

One of the most significant changes affecting podiatry billing in 2026 is Medicare’s revised payment methodology for skin substitute products. CMS has shifted reimbursement for most skin substitutes to an incident-to supply model, replacing traditional ASP-based payments.

This change directly impacts wound care services frequently provided by podiatrists. Documentation must now clearly establish:

  • • Wound size, depth, and progression
  • • Failure of prior conservative treatments
  • • Medical necessity for skin substitute application
  • • Proper linkage between supplies and covered procedures

Without strong documentation, claims involving skin substitutes are at higher risk for denial or underpayment under the new reimbursement structure.

Physician Fee Schedule Updates and Revenue Impact

The 2026 Medicare Physician Fee Schedule includes modest increases to conversion factors and updates to Relative Value Units (RVUs). While podiatry practices may see overall payment increases, those gains can quickly disappear if documentation does not support billed services.

Accurate documentation ensures that:

  • • Work RVUs are fully supported
  • • Modifier usage is justified
  • • Services are coded to their highest appropriate level

Telehealth Documentation Expectations Continue to Evolve

Telehealth remains a viable care delivery option in 2026, but Medicare’s documentation requirements continue to evolve. Podiatry practices offering virtual visits must ensure documentation clearly reflects:

  • • Type of telehealth service provided
  • • Modality used (audio or audio/video)
  • • Medical necessity for a remote visit
  • • Appropriate place-of-service and modifiers

Quality Reporting and MIPS Documentation Considerations

Medicare’s quality reporting programs continue to influence reimbursement. Updates to the Merit-based Incentive Payment System (MIPS) in 2026 require accurate clinical documentation that supports reported quality measures.

Podiatry practices must ensure that documentation aligns with:

  • • Preventive foot care metrics
  • • Chronic condition management
  • • Performance thresholds tied to future payment adjustments

Best Practices for Podiatry Documentation in 2026

To stay compliant and protect revenue under Medicare’s 2026 documentation standards, podiatry practices should adopt proactive strategies:

  • • Standardize EHR documentation templates
  • • Train providers on updated Medicare requirements
  • • Conduct regular internal documentation audits
  • • Monitor high-risk services such as wound care and telehealth
  • • Partner with experienced billing professionals

Conclusion

Medicare documentation changes in 2026 reflect a broader shift toward accountability, cost control, and value-based care. For podiatry practices, success depends on understanding these changes and adapting documentation workflows accordingly.

At JARALL Medical Management, we specialize in helping podiatry practices stay compliant, reduce denials, and optimize revenue. With the right documentation strategy in place, practices can navigate Medicare changes with confidence and financial sta