This quick reference sheet illustrates the coding and documentation requirements for medication management services with, or without psychotherapy.
Archives for December 2025
Coding Guide – Advanced Primary Care Management
Care management services have played an increasing role patient care management. CMS and other payers no longer pay only for face-to-face services, a concept that would have been unthinkable 15 years ago. CMS began paying for Transitional Care Management Services in 2013, for chronic care management services in 2014. In the 2016 Final Rule, CMS […]
Physician Fee Schedule Final Rule for Calendar Year 2026
2026 conversion factor $33.4009 ($33.5675 for qualifying APM participants) – updated 11/4/2025 Payment policies in the 2026 Physician Fee Schedule Conversion Factor For the first time, there are two conversion factors for services paid under the Physician Fee Schedule. This is a result of a law passed in 2015. The Medicare Access and CHIP Re-authorization […]
In Focus: CPT® Coding for Percutaneous Coronary Interventions (PCIs) | Webinar
Recorded January 22nd, 2026
1 CEU Expires 1-30-2027
Guest presenter Shannon McCall of HCPro
In the 2026 revisions to CPT® codes, there are revised guidelines for the section Coronary Therapeutic Services and Procedures. Six existing add-on codes that reported additional interventions in the coronary branches are deleted, and base codes are revised to include the branches of the same coronary artery within the descriptions of the codes themselves.
Billing Preventive Medicine Services and Problem Visit | Quick Reference Sheet
This quick reference sheet provides guidance for billing preventive medicine services and split visits.
Reimbursement Reality: Navigating the 2026 Payment Landscape | Webinar
Recorded January 15th, 2026
1 CEU Expires 1-30-2027
Guest presenter Elizabeth Woodcock
Change remains the only constant in reimbursement for health care services. Stay ahead in 2026 with this essential payment update for medical practices. This session will break down the latest federal payment policies, emerging reimbursement models, and what they mean for your medical practice’s bottom line.
Teaching Physician Rules | Quick Reference Guide
This quick reference guide breaks down who must document what for which services as outlined in Medicare’s teaching physician rules.
Chronic Care Management | Reference Sheet
This quick reference sheet includes clinical staff time, care planning and billing practitioner work criteria for chronic care management services. When coding for care management services services, practitioners need to distinguish between chronic care management and complex chronic care management, between who does the work, the practitioner or clinical staff, and the amount of time […]
Care Plan Oversight | Coding reference sheet
There are two sets of codes for care plan oversight, CPT® (99374–99380) and HCPCS codes (G0181, G0182). The requirements for each are different, including time thresholds and what activities may be included in the CPO time. RVUs are assigned by Medicare for these CPT® codes. Some have a bundled indicator and some invalid, which means […]
E/M Office Visit Scenarios
It can be difficult to translate the E/M rules into patient scenarios that ring true and are applicable to every day clinical encounters. The guidelines seem great in theory, but how does a clinician, coder, or auditor apply them to select the correct level of service? Here are examples based on MDM, not time, that […]
Non-Physician Practitioners in Nursing Facilities
Question: Can a Non-Physician Practitioner (NPP) see patients in a nursing facility without a physician signing each encounter? How do we bill this? Can we do wellness visits in a nursing facility? Answer: Yes, NPPs may care for patients in a nursing home. These can either be billed directly by the NPP, under their own […]
Incident To Services – Medicare
Medicare has specific rules for billing for nurse practitioners and physician assistants and other office staff incident to a physician services in an office. This article includes: Description, explanation and codes for incident-to services Billing and coding rules Brief video overview Enrollment of non-physician practitioners (NPPs) for incident-to billing Pharmacists and Part B Medicare reimbursements […]