Part B News | Benchmark of the Week

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

07/27/2026

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.

Claims up for instrumentation-based ear wax removal procedures

06/29/2026

by: Richard Scott

Clearing blocked cerumen, or ear wax, is far more frequently performed using instrumentation than water irrigation, and providers report millions of the cerumen-removal services per year.

Locum tenens, substitute providers see denial variability

06/22/2026

by: Roy Edroso

Reciprocal billing arrangements and fee-for-time services, popular with providers in summer-vacation season and requiring a modifier to pass through claims adjudication, run the gamut in denial rates by specialty.

Patient relationship modifiers have surged since 2018, and one specialty dominates

06/15/2026

by: Julia Kyles, CPC

Patient relationship category modifiers aren’t mandatory, but they have gained popularity since CMS introduced them in 2018. Providers submitted approximately 170,000 Medicare Part B claims with a patient relationship modifier in 2018. The most recent CMS data shows that providers submitted more than 50 million claims with a patient relationship modifier in 2024.

With denials already high, practices contend with G0136 revamp

06/08/2026

by: Richard Scott

Family practice and internal medicine providers led the way in reimbursement for HCPCS code G0136 in its first year of eligibility, returning more than $1.6 million in payments. But providers should note a significant revision to the code effective in 2026 or risk major compliance challenges.

Family practice leads way with virtual check-in service, while other specialties sputter

05/25/2026

by: Richard Scott

Certain specialties reporting the Medicare-approved virtual check-in service drew miniscule denial rates, with cardiology returning a scant 0.9% denial rate across nearly 7,000 claims. But other specialties, such as nurse practitioner and nephrology, saw elevated denial rates on their billing attempts.

Mandatory ABN use shows low denial rate among most top specialties

05/18/2026

by: Julia Kyles, CPC

Specialties with high utilization of a mandatory advance beneficiary notice of noncoverage (ABN) usually received payment for claims with ABN modifier GA (Waiver of liability statement issued as required by payer policy, individual case). In addition, many, but not all, of those providers frequently forgot to get mandatory ABNs to patients in a timely fashion.

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