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Archives for October 2025

CMS’s Physician Fee Schedule Final Rule

Recorded December 11th, 2025
1 CEU expires 12/30/26

Guest presenter Claire Ernst of Hooper, Lundy & Bookman, P.C.

CMS released the 2026 Final Rule right on time, Friday, Halloween, 4:30 pm. They love a holiday rule release and we love being up-to-date with CMS policy. The agency finalized many of its proposals: variable conversion factor, applying an “efficiency adjustment” to many non-time-based codes, lowered payments for skin substitutes, telehealth updates (but not the updates we were hoping for).

NPP Billing-Shared and Incident to Services | Webinar

Recorded November 20th, 2025
1 CEU expires 11/30/26

Guest presenter Seth Canterbury

Billing for services involving NPPs presents specific challenges. This webinar will provide an in-depth review of Medicare’s current rules for services involving advanced practice providers (NPPs), focusing on the distinctions and documentation requirements for split/shared encounters and incident-to billing.

Leveling a Visit for an Acute, Uncomplicated Presenting Problem

Question: What’s the accurate level of service for a patient who presents with a sore throat, has a positive strep test, and is put on antibiotics? Answer: The September 2025 CPT® Assistant posed this question and said the level of service was 99213. Let’s look at this in grid form to see why. You need […]

Take the guesswork out of Separate Procedures, Global Packages, and E/M Billing Rules

Navigating medical coding can be a challenge, especially when it comes to understanding when procedures and Evaluation & Management (E/M) services are separately billable. Three key concepts—separate procedures, global surgical packages, and E/M modifiers play a critical role in accurate and compliant billing. Let’s break them down. Separate Procedures: When to Bill and When to […]

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