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Latest claims data shows clear preference for telehealth at home

09/07/2026

Patients were almost three times more likely to receive a telehealth service at home than in another location in 2025. But Part B News analysis of data for Part B claims performed in places of service 02 (Telehealth provided other than in patient’s home), with 5.9 million claims, and 10 (Telehealth provided in patient’s home), with 17.3 million claims, revealed denial rates that almost match: 14% and 15%, respectively.

Use scenarios to guide providers toward proper E/M billing

08/31/2026

by: Julia Kyles, CPC

The range of E/M services and ways to bill them continues to expand. But with more billing opportunities comes more confusion about work that can and cannot be billed. While you should train staff to recognize legitimate revenue opportunities, make sure they don’t get too creative when it comes to identifying billable E/M services.

NPs, PAs grow not just in scale and scope, but also expectation

08/31/2026

by: Roy Edroso

The rise of nurse practitioners (NP) and physician associates (PA) in U.S. health care continues with more states granting these providers greater practice autonomy. This growth brings them more opportunities. It also comes with increased practice options that may affect your decision to employ them, or their decision to be employed by you.

Doc-on-doc or inter-staff violence? Act fast and take notes

08/31/2026

by: Roy Edroso

If one of your clinical staff accuses another of assault, you have both administrative and legal responsibilities that you should be prepared to meet before something goes wrong.

How to comment on the proposed 2027 Medicare PFS

08/31/2026

by: Julia Kyles, CPC

You have less than one month to submit your thoughts or questions about the proposed 2027 Medicare physician fee schedule to CMS. The comment period will end Sept. 14, 11:59 p.m., ET.

Maps show spread of independent practice for NPs, PAs

08/31/2026

by: Roy Edroso

While the growth in numbers and earning power of nurse practitioners (NP) and physician associates (PA) is impressive, perhaps their most important advance is in state laws allowing them to practice with limited and even no physician oversight (see related story, p 3).

PFS implements law throwing some foreign-born patients off Medicare

08/24/2026

by: Roy Edroso

The “Limiting Medicare Coverage of Certain Individuals” section of the proposed 2027 Medicare physician fee schedule explains how CMS will enforce a 2025 law that removes some Medicare beneficiaries from the rolls based on immigration status as soon as February 2027. If you have patients affected by this, you may not hear that their services are not covered by Medicare until after they’ve been cut — and it’s not clear that your charges on those patients will be allowed.

Monitor the maternity care coding makeover for 2027

08/24/2026

by: Nancy Reading

Start the countdown: Beginning Jan. 1, 2027, services for antepartum care, labor management, delivery and postpartum care will be coded separately. The old global approach to billing obstetric care was intended to simplify billing, but it no longer reflects the variation and complexity of care across the phases of pregnancy.

Once upon a diagnosis: Why coding the patient’s story is vital

08/24/2026

by: April Russell and Diane Pittman

Ever since the International Classification of Diseases (ICD) was introduced, its purpose has been clear: to capture the reason for a patient’s visit across all health care settings. As outlined in the first paragraph of the ICD-10-CM Official Guidelines for Coding and Reporting, diagnosis coding is intended to describe the patient’s condition using terminology that “includes specific diagnoses as well as symptoms, problems, and reasons for the encounter.”

Providers had little trouble taking sides among modifiers 50, LT and RT

08/24/2026

by: Roy Edroso and Julia Kyles, CPC

Deciding whether to use modifier 50 (Bilateral procedure) or modifiers LT/RT (Left side/right side) requires a little forethought and sometimes homework. Still, in 2024, the most recent year of available Medicare figures, it appears providers didn’t do too badly — though some codes proved more of a challenge.

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