Each year CMS issues a Final Rule for services paid under the Medicare Physician Fee Schedule (PFS). This rule document defines and explains the logic for changes to items as well as potentially explaining coverage and payment issues for the code(s).
Policies and procedures for existing codes are also a part of the PFS Final Rule. Clarifications of existing guidelines and new one are included.
Not only does CMS explain their logic I making their final rule, the document also responds to questions posed after the issuance of the proposed (PFS) rule. This is released earlier in the year. Usually in June or July. These comments offer invaluable reasoning as to what the authors were thinking and to different scenarios for the code or situation.
This audioconference analyzes the historically two thousand pages of information to glean the most important facts for most offices. This information is published in an edition the federal register.
Fees for 2026 are changing. Not only the conversion factor but other items such as a change to the practice expense logic and the creation of differing RVUs for practice expenses.
Dental services continue to evolve in the coverage by Medicare. This expanding area for payment by Medicare is well defined here
The Social Determinants of Health Assessment code is undergoing changes that include a name change.
Telehealth services, although the extension for payment is only extended to January 1, 2026 as of this date, comments on the use of telehealth services after this return to pre-PHE time are helpful.
Virtual supervision has been made permanent. The clarification of this change is explained and the frequency of use of this unique situation defined as in-frequent
Coders, Billers, Office Managers, Office Administrators