Part B News | Part B News

Get ready for 4% cut: Budget shutdown not likely to stop Medicare sequester

09/15/2025

There’s an opportunity for Congress to take advantage of the shutdown threat to head off the extra 2% sequestration cut providers face in 2026, but experts advise against getting your hopes up.

Capture CPT, diagnosis coding for accurate pelvic floor therapy billing

09/15/2025

by: Beth Morgan, CPC, MCS-P

When therapy is recommended for a patient, your mind may turn to physical, occupational and speech therapy. However, there is a new type gaining momentum: pelvic floor therapy. This therapy helps individuals to relax and coordinate their pelvic muscles, and understanding the coding terminology and guidelines specific to pelvic rehabilitation is essential for accurate documentation and billing.

After spike in payments, OIG seeks closer watch on remote monitoring

09/15/2025

by: Richard Scott

Payments for remote physiologic monitoring (RPM) services have skyrocketed under Medicare, surpassing $535 million in 2024. That’s up from just $15 million five years earlier. As services spike, the HHS Office of Inspector General (OIG) is sending out a warning: we’re keeping an eye on you.

OIG: CMS should enforce post-op reporting data during global period

09/15/2025

by: HCPro staff

On August 27, the OIG published a report regarding global surgery data. CMS bundles all services associated with a surgical procedure under its global surgery policy, and it collects information on the number of post-operative visits for a typical patient to help set the valuation for these procedures.

RPM, RTM utilization zooms, and so do RTM denial rates

09/15/2025

by: Roy Edroso

In a series of reports, the OIG warns of possible serious misuse of remote physiological monitoring (RPM) codes, for which Medicare utilization has skyrocketed. OIG clarifies that they’re not talking about remote therapeutic monitoring (RTM) codes, possibly because, from rising denial rates, it appears as if the MACs are doing a good job of spotting bad claims themselves.

Laws on mental health and AI spread; watch liability when adding services

09/08/2025

by: Roy Edroso

States are adding legislative restrictions to artificial intelligence (AI) health care chatbots. While the burden of compliance largely falls on companies who develop and market the products, it’s worth keeping some tips in mind when you contract with vendors.

How OCR leadership changes could escalate HIPAA enforcement

09/08/2025

by: Dom Nicastro

The appointment of Paula M. Stannard in early June as director of the Office for Civil Rights (OCR) signals a return to assertive legal interpretation and enforcement of HIPAA, one steeped in institutional history and a broad view of federal oversight, according to compliance experts.

Counter anti-vaccine publicity with facts and respect

09/08/2025

by: Roy Edroso

Question: Normally we have a fall immunization drive with posters and patient reminders. But the subject seems politically fraught these days. Should we just keep silent about it and let our patients make their own decisions without our input?

Solve common errors in skin substitute claims

09/08/2025

by: HCPro staff

One of the most common errors seen in skin substitute claims is the inappropriate application of drug waste modifiers.

As telehealth use slips, some states drop faster than others

09/08/2025

by: Julia Kyles, CPC

For the second year in a row, one-quarter of eligible Medicare patients took advantage of the expanded telehealth benefits, according to the latest telehealth trends and utilization report from CMS.

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