Training for Your Whole Practice: Billing, Coding, Compliance & More—One Simple Solution $500 OFF When You Subscribe by April 30th

E/M Coding

E/M Coding

E/M downcoding

Stop Losing Thousands: How E/M Downcoding Is Draining Your Practice Revenue in 2026

If your practice feels like it’s working harder but getting paid less, you’re not imagining it. Between Medicare fee schedule cuts, rising overhead, staffing shortages, and increased payer scrutiny, margins are tighter than ever in 2026. Even well-run practices with compliant billing processes are seeing unexplained revenue shortfalls month after month. One of the biggest […]

Expect 5 New Remote Therapeutic Monitoring Codes Jan. 1

Practices that perform remote therapeutic monitoring (RTM) will have the opportunity to collect for these services even if patients aren’t monitored for a full 30 days, thanks to CPT 2026. Five new codes will represent shorter time periods than in the past, and they go into effect on January 1st. Check out a few remote […]
EM services

3 Commonly Downcoded E/M Services & How to Avoid Issues

Your insurer may not announce that they’re downcoding your E/​M services, but it’s likely that one or two claims are being automatically readjusted to lower E/​M levels every month. And for every downcoded claim, your practice is losing money. Check out a few of the most commonly downcoded E/​M services, along with tips on how […]
E/M Downcoding

Cigna Releases 3 New Facts About E/M Downcoding Policy

Cigna’s new E/​M downcoding policy — which will apply to certain high-level E/​M claims — takes effect next week. And as the Oct. 1 implementation date approaches, the payer has finally responded to questions that have been swirling about the new policy. Check out three facts that can help you prepare for the new E/​M […]

How Will CIGNA’s E/M Change Impact Your Practice’s Pay?

If your practice contracts with Cigna Healthcare, you may soon find that your E/​M pay is significantly lower than it used to be. Why? Because a new Cigna E/​M policy, announced July 1, 2025, pledges to downcode some E/​M codes by one level following claim reviews. Read on to find out how the new Cigna […]

Are Revenue Cycle Bottlenecks Costing Your Practice Thousands?

Dr. Lopez’s busy orthopedic practice submits hundreds of claims every week. But with denials creeping up, the billing team is constantly resubmitting claims. One front-desk employee, unfamiliar with payer rules, keeps entering incomplete patient insurance data—forcing staff to chase patients for missing information. Meanwhile, credentialing delays keep a new physician from being properly enrolled with […]
G2211

CMS Adds Nearly 100 More Codes You Can Bill With G2211

If you’ve ever wondered why the add-on code G2211 can’t be billed with a wider range of CPT codes, you’re in luck. On April 29, CMS added 98 additional codes that can be reported along with G2211 as part of an update to Transmittal 13199. Even better news? The implementation date is retroactive to January […]
Incident to

Three Providers Who Were Charged With Incident to Fraud

You’re familiar with billing fraud, egregious upcoding behavior and missing documentation — but are you aware of incident to fraud? Well, it happens more often than you’d think, and can get you into huge trouble. Check out three recent cases of practices who were accused of committing incident to fraud so you can avoid their […]
Incident to

3 Incident To Scenarios to Keep You Compliant With 2025 Rules

When it comes to incident to billing, annual updates have become a “blink and you’ll miss it” ordeal. While it’s easy to keep up with some of the changes, others are hard to catch. One such change happened at the end of 2024, and it’s in effect right now. CMS now allows you to bill […]
G2211

Check These Telehealth Scenarios When G2211 Applies

Ever since G2211 went into effect last year, practices have been using it to collect more from Medicare when seeing patients for longitudinal care. You can bring in an extra $15 or more from MACs for this service, and it may even be applicable for telehealth visits. To straighten out when you can use G2211 […]