Part B News | Part B News

Small rise in Open Payments to MDs in 2024, but NPPs leapt high

02/16/2026

CMS’ Open Payments website has undergone a makeover, and its latest (2024) numbers for payments to physicians from “applicable manufacturers or applicable GPOs” (including drug and device manufacturers) are available there. More money changed hands in 2024 than in 2018, the earliest year for which numbers are publicly available. But it may be less than you expected.

Under-1% proposed rate rise, risk adjustment crackdown fret MA payers

02/09/2026

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

02/09/2026

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

02/09/2026

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.

Cover Medicare documentation requirements for physical, occupational therapy

02/09/2026

by: DecisionHealth staff

Medicare pays for physical and occupational therapy services when the medical record and the information on the claim form accurately report covered therapy services. That means the documentation must be legible, relevant and sufficient to justify the services billed.

QHPs most likely to be involved in assistant-at-surgery claims

02/09/2026

by: Julia Kyles, CPC

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.

Shore up HIPAA Part 2 record-keeping as new rule looms

02/02/2026

by: Roy Edroso

Even if you’re not enrolled as a Part 2 program, you may have reason to study up on a new Part 2 privacy rule, for which the compliance deadline is fast approaching.

Worried about flu spread? Use masks, but check the law

02/02/2026

by: Roy Edroso

With flu spreading fast, it may be time to revisit your in-office masking policies and check for legal issues.

Will your risk analysis stand up to scrutiny? Map out a plan

02/02/2026

by: Dom Nicastro

The Office for Civil Rights (OCR) is clearly watching how organizations evaluate risk assessments, conduct vendor oversight and execute breach preparedness. The findings detailed in OCR’s recent settlement with Comstar LLC were not obscure legal nuances. Instead, they revealed a basic failure to conduct a thorough organization-wide risk analysis, a core expectation under the HIPAA Security Rule.

Use a checklist to prevent real-life virtual direct supervision mistakes

02/02/2026

by: Julia Kyles, CPC

Medicare’s new rule that allows virtual direct supervision gives your providers more flexibility and creates the potential to bill more services under incident-to rules.

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