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Professional Part B Medicare fees are on the upswing overall, but site of service will be a huge factor in reimbursement in 2026. The proposed 2026 Medicare physician fee schedule, released today, boosts the Part B conversion factor for CY 2026, adds billing opportunities for behavioral health services, previews new codes and updates the agency's quality reporting programs.
 
CMS also signaled other notable priorities, including significant changes to the way the agency calculates rate-setting on a per-code basis, a new payment model called the Ambulatory Specialty Model (ASM) that's focused on the treatment of heart failure and lower back pain, telehealth flexibilities and more.
 
 
Guide your team through the updates to the ICD-10-CM guidelines before they go into effect.
 
 
Marketing for artificial intelligence (AI) tools aimed at medical practices is everywhere — and promising everything. But experts warn that you should not rush out and purchase something labeled AI, no matter how exciting the demo or urgent the problem it promises to fix.
 
After earlier reforms that sought to reduce the impact of prior authorization on providers and patients, CMS has created a demonstration model that will add prior authorization requirements for regular Medicare for a select group of regional providers.
 
Selecting a level of medical decision-making (MDM) can be confusing and complicated. There are four levels of MDM: straightforward, low, moderate and high. Each level includes three components that, when used together, determine a level of service.
 

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