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Failed restrictive covenant case signals a warning to practices

09/22/2025

Recently a New Jersey practice lost a suit to enforce a restrictive covenant against a physician they had released. Experts say the case reveals pitfalls that practices should take care to avoid when they write and enforce their noncompetes and other covenants, and ways to get around them if they still come up.

Survey says docs feel MD shortage; go for young recruits, high engagement

09/22/2025

by: Roy Edroso

A Medscape survey of 1,001 physicians suggests that the shortage of health care providers in the U.S. is being felt keenly at ground level, with doctors lamenting a lack of sufficient “qualified applicants” to relieve it. Experts suggest luring recruits with relevant offers and engagement.

E/M office visit payments fall to four-year low, despite high-level code climb

09/22/2025

by: Richard Scott

Higher-level E/M office visit codes for established patients continued to climb in 2024, with significant growth for Level 4 and 5 codes. Yet total payments for the office visit suite (99202-99215) were at their lowest levels in four years.

Beware of signs of lawsuit-prone patients, and keep documentation professional

09/15/2025

by: Julia Kyles, CPC

Train everyone in your practice to take a preventive approach to litigious patients, meaning patients who threaten to file complaints or sue for any reason or no reason at all. Everyone in the practice, from the scheduler to the surgeon, needs to recognize the signs and know how to communicate their concerns about a patient so they don’t make a bad situation worse. The approach also works for patients who are merely difficult and reasonable patients who are considering a lawsuit.

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

09/15/2025

by: Roy Edroso

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.

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