This guide provides rules for reporting fracture care services using CPT® and Medicare guidelines. It details the coding distinctions for closed, percutaneous, and open treatment of fractures, clarifies how casting, splinting, and strapping services are treated within the global surgical package, and addresses the correct use of selected modifiers and radiology and supply codes. The […]
CDI and Coding for Myocardial Injury and Infarction | Webinar
Recorded February 9th, 2026
1 CEU Expires 2-28-2027
Guest presenter Dr. Robert Oubre
Dr. Oubre will provide a practical, clinically grounded review of myocardial injury and myocardial infarction through the lens of accurate documentation and compliant coding
Using Modifier 59 | Quick Reference
Modifier 59 is referred to by CMS as the modifier of last resort. It is often used when modifier 51 is the more accurate modifier. This quick reference sheet explains when, why and how to use it.
Diabetes Coding in V28
This quick reference sheet simplifies coding for diabetes in the HCC system. A must-have resource for clinicians who see patients with diabetes.
Medication Management and Psychotherapy Reference Sheet
This quick reference sheet illustrates the coding and documentation requirements for medication management services with, or without psychotherapy.
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 […]
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 […]
When to Use Time to Select an E/M Service
Selecting a code for an E/M service can be based on time or medical decision making (MDM) (except ED visits which must be selected based on MDM) Time includes all time spent by the billing practitioner on the date of service, not just face-to-face time, and counseling does not need to dominate the visit, as […]
HCPCS Codes for Behavioral Health
Post-discharge Telephonic Follow-up Contacts Intervention | G0544 Digital Mental Health Treatment | G0552, G0553, G0554 Safety Planning Interventions | G0560 Post-discharge Telephonic Follow-up Contacts Intervention HCPCS code: G0544 Descriptor: “Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar […]
Coding Guide – Newborn and Pediatrics
Neonatologists, pediatricians and family physicians who care for newborns and sick children in the hospital need to select the category of code that describes the condition of the patient. There are distinct categories of codes to describe each of these situations. There are also codes that describe services to patients who are in the process of being transferred to a higher acuity facility. This guide describes the codes to use in each situation.
Interactive Complexity | CPT® 90785
Code 90785 is an add-on code for interactive complexity and may be added on to the diagnostic psychiatric evaluation (90791, 90792), psychotherapy services (90833—90838), and group psychotherapy (90853). It may not be reported with an E/M service, if no psychotherapy is performed on that day, or with psychotherapy for crisis, (90839, 90840). +90785 Interactive complexity […]
Annual CPT® Changes | Webinar
Recorded December 18th, 2025
1 CEU expires 12/30/26
Guest presenter Shannon McCall of HCPro
The American Medical Association’s 2026 update to the CPT® Manual is here, with codes and coding changes effective 1-1-2026.
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).
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