Coverage

Review CMS' proposed policy and technical changes to Medicare Advantage (MA) and Part D programs for 2026.

CMS gave the green light to improved payments for high-cost radiopharmaceuticals and made changes to its payment calculation for cardiac CT services among other updates in the 2025 Outpatient Prospective Payment System (OPPS) final rule.

Organizations must prepare for a slew of new codes and billing updates for Part B payment, according to the 2025 Medicare Physician Fee Schedule (MPFS) final rule. The final rule, released November 1, details CMS’ numerous changes to payment rates, billable services, telehealth rules, and other services.

CMS recently issued a final national coverage determination (NCD) for pre-exposure prophylaxis (PrEP) using antiretroviral drugs to prevent HIV in high-risk individuals.

Set the stage for success and close out the year strong.

Jugna Shah, MPH, CHRI, highlights the need for Medicare payment policy changes.

Learn how to ensure your organization is in compliance with CMS’ newest rules.

Take a closer look at major changes in the works for outpatient reimbursement.

Consider how CMS’ proposed changes could impact your organization.