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CMS will expedite the next National Correct Coding Initiative update to stop denials when a provider reports administration of the COVID-19 vaccine and another vaccine code for the same patient on the same day.
 
The Continuing Appropriations and Extensions Act, 2026 (CAE 2026), reactivated the COVID-19 telehealth waivers until Jan. 30, 2026. Better still, the CAE 2026 closed a potential telehealth payment gap by backdating the extension to Sept. 30, 2025.
 
Your providers will see higher conversion factors (CF) in 2026, with a 3.8% boost to those participating in qualifying alternative payment models (APM) and a 3.3% increase for everyone else. Yet a yawning gap in reimbursement levels will confront practices in 2026, depending on whether your providers deliver care in the non-facility or facility setting.
 
 
Members of Congress did not come to a budget agreement before the Oct. 1 start of the fiscal year, and a government shutdown of all but "essential" spending is now in effect. CMS has issued some advice to providers.
 
 
The following article will appear in the 9/29/25 issue of Part B News. Subscribers can access more than 400 articles on telehealth and telemedicine.
 
After five years, most – but not all – of Medicare’s telehealth expansions are scheduled to end at midnight, Oct. 1. Even though one quarter of eligible Medicare patients continue to take advantage of the broader telehealth benefit, it seems unlikely that Congress will pass another last-minute extension or a permanent upgrade to Medicare telehealth law to keep the popular policies in place.
 

 

 

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