As the healthcare industry looks toward 2027, medical practices are encountering significant financial uncertainty. This is due to a temporary Medicare pay raise, a new efficiency adjustment, and stalled progress in legislative solutions. The fleeting nature of the pay bump, combined with ongoing cuts and the lack of a permanent fix, is causing concern among […]
Understanding how physicians are paid is a crucial part of running a successful medical practice, yet many administrators focus solely on the reimbursement checks from insurers without truly understanding how those amounts are determined. In the premiere episode of The Back Office, a new video series and podcast from Physicians Practice, host Lucien W. Roberts III, […]
Physicians have expressed strong opposition to the newly proposed federal spending plan, which fails to address a crucial issue: the 2.83% reduction in Medicare Physician Fee Schedule reimbursement for 2025, representing significant Medicare Physician Reimbursement Cuts. While the House of Representatives Appropriations Committee introduced the bill on March 8, with an anticipated floor vote this […]
Medicare is failing both patients and physicians. After adjusting for inflation, physician reimbursement under Medicare has declined by 33% from 2001 to 2025, according to the American Medical Association. In stark contrast, Medicare payments to hospitals have surged by nearly 60%, while hospital executive salaries have skyrocketed 93% over the past decade. How can private […]
On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2025. The calendar year (CY) 2025 PFS proposed […]
New billing codes: Medical experts might consider creating new billing codes for the time doctors and their support staff spends working on prior authorizations. The American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Board meets May 9-11 in Chicago. On the meeting’s agenda are three potential new CPT codes “for reporting services (physician, QHP, […]
A thorough understanding of the latest guidelines for coding evaluation and management services is necessary to ensure compliant claims. You’ve likely heard about the 2023 CPT® changes for reporting hospital inpatient and observation evaluation and management (E/M) services. AAPC has been preparing medical coders for these changes since they were announced and started offering education […]
Some updates to the evaluation/management codes on the 2021 Physician Fee Schedule will provide greater reimbursement to physicians and allow them to spend more time with patients, CMS and medical societies said. According to CMS, the code sets that it is finalizing will increase the value of certain services. These include: cognitive impairment assessment and care […]








