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Understanding status indicators in the OPPS: Knowledge for medical billing professionals

Thu, 07/17/2025
Leadership Council Insider
Billing and Claims, Coding and Documentation, NAHRI Leadership Council, Revenue Integrity

by Kristen Hunter, RHIA,  CHRI, CCS, CPC, CPMA, CRC, CANPC, CEDC, CEMC, CRCR

CMS prioritizes site neutral payments, price transparency in 2026 OPPS proposed rule

Wed, 07/16/2025
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Price transparency and site neutral payments are back in the spotlight in the 2026 Outpatient Prospective Payment System (OPPS) proposed rule, released July 15. The proposed rule also sees CMS reviving efforts to eliminate the inpatient-only list. It also includes changes to skin substitute payments, further reductions to offset increased payments for non-drug items and services as a result of the vacated 340B policy, and a slew of other changes affecting reimbursement, reporting programs, compliance, and coverage.

2026 MPFS proposed rule includes telehealth updates, changes to skin substitute payment

Wed, 07/16/2025
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

Organizations may see certain telehealth flexibilities become permanent, according to the 2026 Medicare Physician Fee Schedule (MPFS) proposed rule, released July 14. The proposed rule also details significant changes to professional reimbursement based on site of service, skin substitute payments, behavioral health services, and more.

July 2025 OPPS update includes vaccine, skin substitute coding changes

Wed, 07/09/2025
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS released the July 2025 update of the Outpatient Prospective Payment System (OPPS) to communicate coding and billing changes that took effect on July 1.

Best practices for chargemaster management

Wed, 07/09/2025
Revenue Integrity Insider
Chargemaster and Charge Capture, Revenue Integrity

Apply these best practices and expert tips to chargemaster management.

Download the July 2025 issue of the NAHRI Journal

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Payer Contracting, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Get connected to your revenue integrity network.

Your revenue integrity network

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Get connected to your revenue integrity network.

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NAHRI Forum
Wed, 07/12/2017 - 13:31
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