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The Opening Gift: How the Fee Schedule Works (and Why It Feels Like Secret Santa) Imagine the anticipation every fall: CMS, Congress, medical specialty societies, and every practice across the country are prepping for the big reveal—the Medicare Physician Fee Schedule (MPFS) for the next year. But this isn’t just opening presents. It’s a carefully […]
When the Calm of Summer Gives Way to Autumn Chaos The easy pace of summer has faded into fall’s familiar rush — lunchboxes packed before dawn, school bells ringing, and inboxes overflowing. For healthcare providers, that same hectic rhythm feels familiar: CMS has announced another delay, extending its hold on telehealth‑related Medicare claims. According to the October 15 MLN Connects Newsletter, CMS directed all Medicare Administrative Contractors (MACs) to continue temporarily
It’s October 2025, and while football fans are glued to unpredictable plays this season, healthcare providers are stuck watching their own kind of gridiron drama — Medicare’s latest “hold everything” game plan. The Play-by-Play CMS has directed Medicare Administrative Contractors to continue holding claims affected by expired payment provisions — that means telehealth, ground ambulance, and FQHC claims are all
Well, folks, here we are—October 2025, and the telehealth roller coaster just took another sharp turn. Congress hit the snooze button, the government is doing its best “out of office” impression, and those cozy pandemic-era telehealth rules officially bid us farewell at midnight on September 30. So, if you were betting on virtual visits being
Not long ago, the idea of checking a patient’s vitals from miles away seemed futuristic. But as healthcare faced the dual pressures of rising chronic disease and aging populations, Remote Patient Monitoring (RPM) emerged as a powerful solution—turning home devices into daily health checkpoints and transforming how we think about outpatient care. Today, RPM is
CMS Proposed rule and what it means for RPM.
Listen up, doctors, suppliers, and anyone billing Medicare for patient care! There’s a new wrinkle in the world of enrollment – the “stay of enrollment.” Don’t worry, it’s not a complete shutdown, but it is a yellow card from Medicare. So, What Exactly is a Stay of Enrollment? Think of it like a temporary hold
During the past two years there has been a lot of conversation about remote patient monitoring. Implementing remote patient monitoring (RPM) in a medical practice can bring many benefits, such as improved patient outcomes and cost savings. However, it’s important to approach the implementation process thoughtfully and with a plan in place. Here are some
We’ve heard a lot about RPM and the ability to gain significant revenue just by implementing the program in your healthcare organization. In this two-part series we’ll talk about the financial benefits, as well as things to keep in mind in order to effectively implement an RPM program. The financial benefits of implementing remote
We get this question many times. What is HCC coding and why is it important? I wanted to take some time to give some background to this question. Hierarchical Condition Categories (HCC) coding is a system used by Medicare Advantage plans to classify and reimburse healthcare providers for the care of patients with chronic