Part B News | Editors' Blog

Q&A: Practices brace for modifier 25 cuts with anxiety, questions

by: Richard Scott Oct 9, 2026

The latest issue of Part B News returns to a topic that is currently roiling the provider community: CMS' proposal to slash fees for modifier 25-appended claims by up to 50% for some services. The proposal, as recent analysis shows, has massive billing and payment implications.

LCD alert: New uniform LCD covers 12 chronic pain treatments in 38 states

by: Julia Kyles, CPC Sep 29, 2026

Take note if your practice treats chronic pain caused by carpal tunnel syndrome, Morton’s neuroma, osteoarthritis of the knee, trigeminal neuralgia and more: Practices in 38 states need to prepare for new coverage guidelines for these and other conditions before the end of October.

Commenters target 'disastrous' modifier 25 proposal that would slash fees by 50%

by: Richard Scott Sep 2, 2026

CMS wants to diminish payments for claims submitted with modifier 25 by 50% in some cases, and providers and others in the medical practice community are not pleased.

The fee cut, which "undermines patient-centered care," would be "disastrous," according to public comments shared with CMS in response to the proposed 2027 Medicare physician fee schedule.

How to comment on the proposed 2027 Medicare physician fee schedule

by: Julia Kyles, CPC Aug 14, 2026

You have one month to submit your thoughts or questions about the proposed 2027 Medicare physician fee schedule to CMS.

Breaking: Conversion factor dips as CMS proposes cuts, floats major coding updates

by: DecisionHealth staff Jul 14, 2026

Brace for impact: CMS announced a reduction to physician fees for CY 2027 that would, in aggregate, lower professional fees across services in 2027. The conversion factor (CF), one of CMS’ primary ratesetting mechanisms, would drop between 1% and 2% depending on the professional fee setting.

CMS also announced in the proposed 2027 Medicare physician fee schedule, released today, that it may seek an alternative method of calculating fees in a repudiation of the AMA’s valuation system. In fact, the agency questions whether it should move away from the CPT code set entirely. Also, CMS is eyeing a revamped system for primary care payments and is teasing new codes that are set to come online next year.

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