Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
ICD-10-CM FY 2027 Takes Effect October 1: 190 New Codes and a Cutover Checklist
The FY 2027 ICD-10-CM update, with 190 new codes, 30 deletions and four revised titles, applies to all encounters on or after October 1, 2026. Here is what changed, the codes primary care and specialty practices will actually use, and the cutover checklist to run in the nine days that remain.
MIPS 2027 Proposed Changes: Core Measures, MVPs and the End of Traditional MIPS
The CY 2027 Physician Fee Schedule proposed rule carries the biggest Quality Payment Program changes in years: a required MIPS core measure, three new MVPs, a plan to sunset traditional MIPS after 2028 and a new electronic prior authorization measure. Comments close September 14, 2026. What small practices should read.
Medicare 2026-2027 Flu Vaccine Payment Allowances: Codes, Rates, Roster Billing
CMS posted the Medicare Part B payment allowances for the 2026-2027 flu season on July 31, effective August 1, 2026. High-dose, adjuvanted and recombinant vaccines all land at $122.52 this year. Here are the codes, the rates, the administration rules and the flu clinic setup we recommend before September.
Medicaid Work Requirement Rule Takes Effect July 31: A Front-Desk Guide
CMS's June 1, 2026 interim final rule on Medicaid work requirements takes effect July 31. States must finish initial outreach by August 31, run the 80-hour test by January 1, 2027, and move expansion adults to six-month renewals. Here is the timeline and the front-desk workflow.
PAMA Lab Data Reporting 2026 Closes July 31: Which Office Labs Must Report
The clinical laboratory fee schedule data reporting window that opened May 1 ends this Friday, July 31, 2026. Many physician practices with in-office labs are applicable laboratories and do not know it. We explain the two tests, what has to be reported, how, the penalties, and what the 2026 appropriations law changed.
CY 2027 Physician Fee Schedule Proposal: Conversion Factor Falls to $32.84
CMS released the CY 2027 Medicare Physician Fee Schedule proposed rule on July 14, 2026. The 2.5 percent bump expires, the conversion factor drops to $32.84, G2211 becomes a 16 percent modifier and same-day E/M visits with globals are cut in half. What happened and what to do before September 14.
ACA Insurers Propose a 14% Median Premium Increase for 2027: Practice Impact
KFF's July 8 analysis of 77 Marketplace insurers in 16 states and DC found a median proposed premium increase of 14 percent for 2027, the second straight year of double-digit requests. For practices that means plan switching, higher deductibles and self-pay conversions in January. Here is how to prepare.
CY 2027 OPPS and ASC Proposed Rule: What Office Practices Should Read
CMS released the CY 2027 hospital outpatient and ASC proposed rule on July 2, 2026. Most of it is written for hospitals, but the botulinum toxin prior authorization expansion, site-neutral imaging and the inpatient-only list phase-out reach physician practices. Here is what to read and what to skip.
Medicaid Provider Tax Changes on June 30 and October 1, 2026: What They Mean
Two dates this year begin the unwinding of Medicaid provider taxes under last year's budget law: non-uniform managed care tax arrangements end with most state fiscal years on June 30, and provider tax rates are frozen from October 1. What the law does, the phase-down that follows, and why practices should care.
Page 1 of 5 · 44 articles
Want this level of attention on your own revenue cycle?
The same people who write these articles run billing, coding, denial management and credentialing for practices nationwide.