Part B News | Ask a Part B News Expert

Subletting a doctor’s office? Make sure you’re covered, not coasting

03/02/2026

Question: I saw a recent article in the New York Times that discussed, among other things, physicians subletting their or other doctors’ offices. The story had a real estate focus, though, and didn’t get into the legal and regulatory requirements for physicians who do this. What should prospective sublessees be thinking about?

Know when add-on behavioral codes apply to the APCM code set

02/16/2026

by: HCPro staff

Question: How has the 2026 Medicare physician fee schedule final rule, effective Jan. 1, 2026, affected coding of advanced primary care management (APCM)?

More certainty required: A possible threat doesn’t meet critical care definition

01/19/2026

by: Julia Kyles, CPC

Question: Would a possible threat to a limb meet the requirement for a critical care service?

When ADRs appear, ensure timely responses, go electronic

01/12/2026

by: HCPro staff

Question: Why is it important to respond to additional documentation requests (ADR) in a timely manner?

Overdose coding: What to know when choosing the right diagnosis

12/22/2025

by: Son Hoang

Question: What is the difference between intentional and unintentional overdoses?

Tylenol accusations are thin, but be safe and mention to patients anyway

11/10/2025

by: Roy Edroso

Question: Recently HHS made some frightening accusations about Tylenol and pregnant women, and the Texas Attorney General has brought suit against the makers of Tylenol for “deceptively marketing Tylenol to pregnant mothers.” My question is: Can our doctors get into trouble now for recommending or prescribing Tylenol?

See why it’s vital to capture history and exam during E/M encounters

08/25/2025

by: HCPro staff

Question: What role do the history and exam play in determining the level of an evaluation and management (E/M) service? Are they optional?

Written protocol for inappropriate behavior, however mild, can help

07/14/2025

by: Roy Edroso

Question: We have a patient who sometimes brings gifts such as flowers or candy to his provider. The provider has shared with us that she finds this awkward and has asked him to stop, but the patient persists. We have a harassment policy, but it seems like overkill to bring it to bear here. What should we do?

The doc’s practice did the imaging test. Can we still count it toward MDM?

07/14/2025

by: Laura Evans, CPC

Question: How would you count the following tests toward medical decision-making (MDM) in the following two scenarios?

The physician orders an MRI at today’s visit for the patient’s right ankle. His practice performs the MRI three days later and bills the professional and technical component.
The physician orders a CT scan at today’s visit for the patient’s right ankle and the CT is performed on the same date by the physician’s practice, which then bills the professional and technical component for the scan...

Stick to your documentation standards for self-pay services

06/23/2025

by: Julia Kyles, CPC

Question: Our providers have started to perform some services that are 100% patient pay, such as platelet rich plasma injections to treat pain. Do we need a separate policy for documenting services when the record doesn’t need to support a code?

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