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Question: Recently HHS made some frightening accusations about Tylenol and pregnant women, and the Texas Attorney General has brought suit against the makers of Tylenol for “deceptively marketin... More

NPP Report

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More

Benchmark of the Week

Prior authorization requests for eight types of services performed in the hospital outpatient setting took a great leap forward in fiscal year (FY) 2024. But there’s good news: While requests ... More

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Question: Recently HHS made some frightening accusations about Tylenol and pregnant women, and the Texas Attorney General has brought suit against the makers of Tylenol for “deceptively marketin... More

NPP Report

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More

Benchmark of the Week

Prior authorization requests for eight types of services performed in the hospital outpatient setting took a great leap forward in fiscal year (FY) 2024. But there’s good news: While requests ... More

Do extra housekeeping as post-shutdown payments clear

by: Roy Edroso

Take the 2026 Part B News Predictions Survey!

by: Richard Scott

CMS, private payers respond to COVID-19 vaccine administration snafu

by: Julia Kyles, CPC

Current and new descriptors for 21 CPT codes – 2026

Get a head start on revisions to codes in the E/M, cardiovascular, radiology and medicine chapters of the 2026 CPT Manual. The following chart contains the current and revised long descriptors for codes that CMS released in the proposed 2026 Medicare physician fee schedule and intends to assign an active (A) payment status

CY 2026 work RVUs for new, revised and potentially misvalued codes

You'll find a preview of more than 90 CPT codes that CMS plans to cover in 2026 inside the proposed 2026 Medicare physician fee schedule. While the codes themselves take a placeholder five-digit sequence, the full descriptors and work relative value units (RVU) are available, providing insight on the services soon to be and the monetary value placed on them.

Prior auth requests swelled, but denials didn’t follow

Prior authorization requests for eight types of services performed in the hospital outpatient setting took a great leap forward in fiscal year (FY) 2024. But there’s good news: While requests nearly doubled from FY2023 to FY2024, denials did not keep pace.

2026 top code payments a far cry from the lean years

In the 2026 physician fee schedule final rule, the difference between the non-facility fees for non-APM participants and APM participants – a signal feature of the new rule, with two distinct conversion factors (CF) – may seem small at first glance. But it gets bigger as the number rise and compares favorably with recent years’ fees.

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