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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
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
Biden administration announces end to Covid-19 Public Health Emergency (PHE) The emergency declarations related to the Covid -19 pandemic will expire on May 11th, according to the Biden administration. “The COVID-19 national emergency and public health emergency (PHE) were declared by the Trump Administration in 2020,” the Office of Management and Budget said in a statement.
As a reminder, Covid-19 Accelerated and Advanced Payments repayment will begin this year. The Continuing Appropriations Act established that repayment will begin “one year from the issuance date of each provider or supplier’s accelerated or advanced payment” Medicare will automatically recoup 25 percent of the Medicare payments owed for eleven months, If full recoupment is
The Senate passed legislation last week to extend the pause on the 2% sequestration reduction through December 31, 2021. The house is expected to take up the bill the week of April 13, 2021, when it returns for a session after the holidays. It is fully expected that the bill will be passed through the
There is some good news for providers who requested and received Medicare advance payments. H.R. 8337 Continuing Appropriates Act, 2021, and other Extensions Act states made some changes for repayment for of the Accelerated/Advance Payment that was offered to providers. The changes are: 1. The automatic payments will be extended to now begin one year