Part B News | Benchmark of the Week

E/M visit complexity code G2211 surges in second year of reporting

09/21/2026

Eleven specialties reported the visit-complexity add-on code G2211 more than 1 million times apiece in 2025, with total claims topping 45 million and payments nearing $455 million, both figures up significantly from the previous year.

Latest claims data shows clear preference for telehealth at home

09/07/2026

by: Julia Kyles, CPC

Patients were almost three times more likely to receive a telehealth service at home than in another location in 2025. But Part B News analysis of data for Part B claims performed in places of service 02 (Telehealth provided other than in patient’s home), with 5.9 million claims, and 10 (Telehealth provided in patient’s home), with 17.3 million claims, revealed denial rates that almost match: 14% and 15%, respectively.

Maps show spread of independent practice for NPs, PAs

08/31/2026

by: Roy Edroso

While the growth in numbers and earning power of nurse practitioners (NP) and physician associates (PA) is impressive, perhaps their most important advance is in state laws allowing them to practice with limited and even no physician oversight (see related story, p 3).

Providers had little trouble taking sides among modifiers 50, LT and RT

08/24/2026

by: Roy Edroso and Julia Kyles, CPC

Deciding whether to use modifier 50 (Bilateral procedure) or modifiers LT/RT (Left side/right side) requires a little forethought and sometimes homework. Still, in 2024, the most recent year of available Medicare figures, it appears providers didn’t do too badly — though some codes proved more of a challenge.

High-volume procedures show mainly fee drops under 2027 proposals

08/10/2026

by: Richard Scott

The 2027 Part B conversion factor is down between 1.2% and 1.7% depending on whether your group is working as an advanced alternative payment model (APM), according to CMS’ proposals. That will have an impact on high-volume services that are reported with frequency.

Fee preview: More losers than winners in PFS proposed fees

08/03/2026

by: Roy Edroso

If the proposed 2027 Medicare physician fee schedule figures were finalized as is, providers would see fee cuts on about three times as many codes as fee gainers.

Catch new file from CMS for top specialties by RVUs, enrollment

07/27/2026

by: Julia Kyles, CPC

In response to comments about its specialty impact table, CMS has created a file designed to “offer interested parties’ additional information that addresses concerns about the lack of granularity in our impact tables,” CMS wrote in the proposed 2027 Medicare physician fee schedule. To show how the impacts can vary, the agency created a file that “models the expected percentage change in total RVUs per practitioner."

Practices take modest approach to caregiver training after 2024 debut

07/20/2026

by: Richard Scott

Medical groups took a slow embrace of caregiver training services (CTS) after CMS rolled out three codes eligible for Medicare billing in 2024. But practices still cleared more than half of a million dollars in payments for the codes, hinting at greater potential ahead.

Screenings get healthy use, but watch some denial traps

07/13/2026

by: Roy Edroso

The top 10 preventive screening codes under Medicare have stayed fairly uniform over the past few years, and their overall utilization continues to ride on a post-COVID rise. But some codes get denied more often than providers might expect.

Fewer claims with modifier 25 won’t automatically reduce denials

07/06/2026

by: Julia Kyles, CPC

Don’t assume your denial rate for claims with modifier 25 (Significant, separately identifiable evaluation and management [E/M] service by the same physician or other qualified health care professional on the same day of a procedure or other service) went down if you reported fewer claims with the modifier.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.