Skip Navigation LinksHome | Editors' Blog
 
As Medicare payment ramps back up after the recent government shutdown, Ahzam Afzal, CEO and co-founder of Puzzle Healthcare in Detroit, points out some things to watch for as the claims and payments come through.
 
 
A flurry of payment and policy changes are coming in 2026, from significant place of service (POS) pay disparities to revamped incident-to billing rules and much more.
 
How will your practice react to the changes in the new year?
 
 
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.
 

Login

User Name:
Password:
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Blog Archive
Back to top