The Centers for Medicare and Medicaid Services (CMS) has issued the notice of benefit and payment parameters for 2026 proposed rule, which outlines important changes affecting health plans on the Affordable Care Act (ACA) marketplace. These proposals aim to refine enforcement mechanisms, improve consumer [...]
On Oct. 2, 2024, the Centers for Medicare & Medicaid Services (CMS) announced that it will accelerate and advance payments to Medicare fee-for-service providers and suppliers to offer support in the event of financial difficulties resulting from Hurricane Helene. Accelerated and advance payments associated [...]
The Office of Inspector General (OIG) recently released a report, "Additional Oversight of Remote Patient Monitoring in Medicare is Needed." It highlights the growing use of remote patient monitoring (RPM) services in Medicare and underscores the need for stronger oversight to ensure the proper [...]
On Sept. 23, 2024, the Centers for Medicare & Medicaid Services (CMS) announced that due to the Change Healthcare cyberattack, clinicians, groups, subgroups, virtual groups, and alternative payment model (APM) entities will be allowed to request a reweighting of one or more Merit-based Incentive [...]
On Sept. 9, the Department of Health and Human Services, Department of Labor, and Department of the Treasury published final rules amending federal regulations to improve access to care for mental health and substance use services. The final rules implement the Paul Wellstone and [...]
The American Medical Association (AMA) has released the CPT 2025 code set, featuring 420 updates that include 270 new codes, 112 deletions, and 38 revisions. Category III codes, which are temporary codes established for new and emerging technologies to allow data collection and are [...]
On July 8, the Centers for Medicare & Medicaid Services (CMS) filed the 2025 Medicare physician fee schedule and Quality Payment Program proposed rule, which includes potential revisions to payment policies under the physician fee schedule, quality payment program and other Medicare Part B [...]
In 2023, new ICD-10 codes were introduced to better capture the distinctions of sleep-related issues, reflecting growing awareness of their impact on health. ICD-10 “Z” codes are diagnostic codes in the International Classification of Diseases, 10th Revision (ICD-10), used to represent factors that influence [...]
On Aug. 26, 2024, the Centers for Medicare & Medicaid Services (CMS) released a list of frequently asked questions related to the office/outpatient (O/O) evaluation and management (E/M) visit complexity add-on code HCPCS G2211. CMS updated the guidance concerning this code, effective Jan. 1, [...]
The AASM signed on to an American Medical Association letter urging Congress to reform the Medicare Access and CHIP Reauthorization Act (MACRA), emphasizing the growing unsustainability of the current Medicare physician payment system and the necessity for policy changes to tackle possible adverse effects [...]