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Address answers, new codes, permanent expansions in telehealth update

11/24/2025

While the fate of popular telehealth waivers created during the COVID-19 public health emergency remains in limbo — due to the recent shutdown-ending legislation that only extended the waivers through Jan. 30, 2026 — Medicare’s original telehealth remains intact, and the agency included five expansions and clarifications in the final 2026 Medicare physician fee schedule.

CMS slaps uniform payment rate on skin substitutes, applies incident-to rules

11/24/2025

by: Laura Evans, CPC

Get ready for a reduction in reimbursement for so-called skin substitutes, the externally applied grafts used to treat non-healing diabetic foot ulcers and venous leg ulcers.

Shared Savings pushes risk, but experts debate the impact

11/24/2025

by: Roy Edroso

Most of the significant changes to the Medicare Shared Savings Program (MSSP) have been confirmed in the final 2026 Medicare physician fee schedule, with a major emphasis on making it easier for new and slow-to-advance entrants to take on risk. However, experts aren’t sure it’ll work.

MDPP gets easier, but providers don’t get a pay raise

11/24/2025

by: Roy Edroso

CMS has kept most of the changes from the proposed rule that would make the Medicare Diabetes Prevention Program (MDPP) easier on suppliers and participants alike, though it remains to be seen whether that raises the program’s low adoption rates despite persistent low payment rates.

2026 PFS round-up: CMS quiet on dental updates, work RVU changes

11/24/2025

by: Roy Edroso and Julia Kyles, CPC

The final 2026 Medicare physician fee schedule, released Oct. 31, delivers major payment and policy updates that take effect in 2026. Take a closer look at some of the more under-the-radar regulatory changes coming in the new year.

2026 top code payments a far cry from the lean years

11/24/2025

by: Roy Edroso with additional reporting by Laura Evans, CPC, and Julia Kyles, CPC

In the 2026 physician fee schedule final rule, the difference between the non-facility fees for non-APM participants and APM participants – a signal feature of the new rule, with two distinct conversion factors (CF) – may seem small at first glance. But it gets bigger as the number rise and compares favorably with recent years’ fees.

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