Under-1% proposed rate rise, risk adjustment crackdown fret MA payers
By: Roy Edroso
An exceedingly modest proposed rate increase for Medicare Advantage payers may signal the end of the Trump administration’s Medicare Advantage honeymoon. It also could forecast a threat to provider payments, as well as higher premiums and more cuts to the benefits of beneficiaries.
Follow 3 steps when you report an assistant-at-surgery modifier
By: Julia Kyles, CPC
Take three steps when an assistant surgeon helps during a procedure. First, make sure an assistant at surgery modifier is appropriate for the procedure. Second, make sure the primary surgeon’s note explains why they needed the help of a qualified health care professional (QHP) or another physician for the procedure. Third, make sure you select the correct modifier, based on the assistant’s credentials and role.
Wrap in 2026 ICD-10-CM updates for the flank, genetic disorders
By: Nancy Reading, BS, CPC, CPC-P, CPC-I
The ICD-10-CM update for 2026 incorporated 487 new codes, revised 38 codes and deleted 28 codes. This included 213 new codes that incorporated the “flank” as an anatomic area related to injuries and 116 new codes for chronic non-pressure skin ulcers. These new codes went into effect October 1, 2025.
Part B News Features
Ask a Part B News Expert
Question: Would a possible threat to a limb meet the requirement for a critical care service?... 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
A physician can serve as an assistant at surgery, but Medicare Part B claims data show that a qualified health care professional (QHP) is most likely to answer the call when the primary surgeon need... More
Ask a Part B News Expert
Question: Would a possible threat to a limb meet the requirement for a critical care service?... 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
A physician can serve as an assistant at surgery, but Medicare Part B claims data show that a qualified health care professional (QHP) is most likely to answer the call when the primary surgeon need... More
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Part B News Blog
Feb 11, 2026
You're invited to speak at Billing & Compliance, Advanced Specialty Coding Summits
by: Richard Scott
Feb 10, 2026
The list of ASM participants is out. Are you in?
by: Julia Kyles, CPC
Feb 4, 2026
Telehealth waivers secure through 2027, watch controlled Rx deadlines
by: Julia Kyles, CPC
Tools
Update to the list of designated health services – 2026
Find the latest list of designated health services (DHS) that are subject to the Stark physician self-referral rule’s restriction on referrals. The new list went into effect Jan. 1, 2026.
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
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Benchmark of the Week
QHPs most likely to be involved in assistant-at-surgery claims
A physician can serve as an assistant at surgery, but Medicare Part B claims data show that a qualified health care professional (QHP) is most likely to answer the call when the primary surgeon needs an extra pair of hands that are guided by advanced clinical training.
Prolonged services E/M code gains favor as practices gain millions
In the four years since prolonged services code G2212 made its debut in 2021, practices have ramped up their use of the 15-minute add-on code, with claims surging 88% between 2021 and 2024.
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Learning Opportunities
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