The Centers for Medicare & Medicaid Services (CMS) has issued the CY 2026 Medicare PFS Final Rule (CMS-1832-F), and it brings major updates to payment policies under Medicare Part B. Here’s what you need to know: Separate Conversion Factors: Beginning in 2026, two conversion factors will apply—one for qualifying alternative payment model
🚨 Medicare Telehealth Update – Effective Today (October 1, 2025) Section 2207 of the Full-Year Continuing Appropriations and Extensions Act, 2025 extended many pandemic-era telehealth flexibilities only through September 30, 2025. Starting today, several pre-COVID statutory limitations are back in effect for most Medicare telehealth services: Geographic restrictions are back — telehealth services must now be provided in
The Office of Inspector General (OIG) just released a critical audit revealing that 77% of trauma team activation claims submitted to Medicare between 2020 and 2022 did not meet federal requirements. Key Findings: $2.4 billion in estimated unallowable charges. 107 out of 125 sampled claims failed to meet Medicare criteria. Common issues included: No prehospital notification. Trauma
The October 1st implementation date for the 2026 ICD-10-CMS and ICD-10-PCS changes are quickly approaching. Do you have an implementation plan? The updates bring both condition and technology specific changes and broader coding clarifications for ICD-10-CM in which clinical and coding staff should be aware. ICD-10-CM Key Highlights: New guidance
The Centers for Medicare & Medicaid Services (CMS) has released the CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed Rule (CMS-1834-P). This sweeping proposed rule outlines new payment policies, transparency requirements, and quality program updates that will shape how outpatient care is delivered and
The Centers for Medicare & Medicaid Services (CMS) has issued the CY 2026 Medicare PFS Proposed Rule (CMS-1832-P), and it brings major updates to payment policies under Medicare Part B. Here’s what you need to know: Separate Conversion Factors: Beginning in 2026, two conversion factors will apply—one for qualifying alternative
