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The Centers for Medicare and Medicaid Services (CMS) recently released the proposed CY 2027 Physician Fee Schedule (PFS), which includes updates to the Quality Payment ... Read more

The Centers for Medicare and Medicaid Services (CMS) recently released the proposed CY 2027 Physician Fee Schedule (PFS), which includes updates to the Quality Payment ... Read more

The Centers for Medicare and Medicaid Services (CMS) recently released the proposed CY 2027 Physician Fee Schedule (PFS), which includes updates to the Quality Payment ... Read more

The Centers for Medicare and Medicaid Services (CMS) recently released the proposed CY 2027 Physician Fee Schedule (PFS), which includes updates to the Quality Payment Program (QPP) and the Merit-based Incentive Payment System ... Read more

Accurate documentation of independent interpretations plays a critical role in supporting compliant coding and can be the difference between assigning an E/M level 99284 or ... Read more

Reporting Outside Image Reviews When a radiologist is asked to provide a “second opinion” or “overread” of images acquired at an outside facility, the service ... Read more

Effective 2027, CPT changes are coming to the Labor and Delivery section of the CPT code set. The good news for anesthesia providers: these changes ... Read more

By Jessica Carden, PESCSenior Director, Provider Enrollment CMS is continuing to crack down on providers, revoking their eligibility to receive reimbursement for services rendered to ... Read more

Now that we are halfway through 2026, it is a good time to confirm that billing workflows, systems, and templates reflect the CPT changes that took effect ... Read more

Released July 14, 2026  |  Comment period open through September 14, 2026 Summary On July 14, 2026, CMS released the CY 2027 Medicare Physician Fee ... Read more

Why This Matters: The Cost of Missed Doppler Add-On Revenue  Transesophageal Echocardiography (TEE) Doppler imaging is increasingly standard in cardiac care, but many coding and ... Read more

QUICK ANSWER: Medicare reimburses waste from single-dose/single-use vials when the correct JW (waste documented) or JZ (zero waste) modifier is reported. Multi-dose vials don’t qualify. ... Read more

Value-based care has raised the bar for how providers demonstrate their role in a patient’s episode of care. The Centers for Medicare & Medicaid Services ... Read more

Sepsis remains one of the most challenging conditions across the continuum of acute care. Its presentation can be subtle, its progression rapid, and its management highly dependent ... Read more

Hospice patients who present to the emergency department often require urgent evaluation for conditions that may or may not be related to their terminal illness. ... Read more

Strategy, AI, and the New Economics of Radiology  RBMA Paradigm 2026 brought radiology leaders together at a moment when the industry is facing rapid acceleration—of ... Read more

The Centers for Medicare & Medicaid Services (CMS) has proposed a 0.09% increase in Medicare Advantage (MA) payments for 2027, amounting to over $700 million ... Read more

Managing joint vs. non‑joint uncertainty at the time of ordering Accurate MRI authorization starts with a clear understanding of what is being imaged. For upper ... Read more

Continuing from last month’s Telemedicine Tips, which included guidance and resources, this month’s focus shifts toward the appropriate documentation for prolonged telemedicine visits. While telemedicine ... Read more

By Jamie Shoemaker, MD, FACEP When deployed thoughtfully in revenue cycle management (RCM), AI is not about replacing clinicians or coders—it’s about defending the care ... Read more

By Jessica Carden, PESC Senior Director, Provider Enrollment One of the most important trends in Medicaid today is the continued growth of Managed Medicaid enrollment. In ... Read more

Anesthesia practices operate in some of the most operationally complex billing environments in healthcare. They face high patient volumes, time-based billing requirements, detailed documentation standards, ... Read more

Congress passes spending bill, extended Telehealth Flexibilities  Congress has extended the expiration dates for certain telehealth flexibilities from Jan 30, 2026, to Dec 31, 2027 (unless otherwise stated), as follows:  ... Read more

By Nettie McFarland, RHIT, CCS-P, CHC Director, Provider Education Support Artificial intelligence (AI) is reshaping documentation in emergency medicine. Voice-to-text, ambient scribing, and predictive charting ... Read more

Comprehensive documentation is essential to demonstrating medical necessity in today’s evolving regulatory environment. Incomplete or nonspecific clinical detail can lead to denials, rework, delayed payments, ... Read more

Although the principal surgeon oversees the patient’s case, assistant surgeons may be necessary when the procedure or patient’s condition is complex. The assistant surgeon performs ... Read more

By Rachel McVey, MBA, CPMSM, CPCO, CHCSenior Director, Provider Enrollment In January 2026, the Council for Affordable Quality Healthcare (CAQH), the central provider data platform ... Read more

As the dust settles on 2026 ASA ADVANCE in Las Vegas, we’re energized by the conversations and strategic insights shared by hundreds of anesthesia physician leaders. Across sessions and hallway discussions, ... Read more

Co-Authored By: As an emergency physician, healthcare revenue experts, and a team deeply engaged in the world of reimbursement and physician advocacy, we’ve seen firsthand ... Read more

By Jamie Shoemaker, MD, FACEP Anthem Blue Cross Blue Shield (part of Elevance Health) has finalized a Facility Administrative Policy: Use of a Nonparticipating Care Provider, ... Read more