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You’re not alone if you don’t know how to confirm a provider's advanced alternative payment model particpation status.That information will tell the conversion factors for their physician fee schedule and anesthesia services in 2026 and beyond.
 
 
Medicare’s rules for prior authorization requests (PAR) for certain procedures performed in the hospital outpatient department (HOPD) are designed to prevent abusive utilization and billing. The Dec. 8 issue of Part B News reveals a skyrocketing rate of prior authorization requests.
 
 
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.
 

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