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.

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.

Change ahead: Understanding the implications of the 2026 IPPS proposed rule

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Gain insights into the potential impact of proposed changes to hospital reimbursement.

New Medicare appeal process: Financial implications abound

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Revenue Integrity

Navigate the complexities of CMS’ newest appeal process.

Preparing for the telehealth policy cliff

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Understand the latest telehealth billing and coding rules.

Ensuring appropriate coding and documentation for skin substitute claims

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Coding and Documentation, Compliance, Coverage, Revenue Integrity

Ensure your organization is in compliance with coding and documentation requirements for skin substitute claims.

CMS launches new model to test prior authorization improvements

Wed, 07/02/2025
Revenue Integrity Insider
Billing and Claims, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS recently announced it will partner with companies specializing in enhanced technologies to test improvements to prior authorization processes via a new Innovation Center model.

How to keep up with changing rules and regulations

Wed, 06/11/2025
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, Payer Contracting, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Learn how to stay current with and navigate changing reimbursement rules and regulations to protect revenue and avoid compliance pitfalls.

Breaking Down the 2026 IPPS Proposed Rule

Fri, 06/06/2025 - 17:55
Webinars
Billing and Claims, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Kimberly A. Hoy, JD, CPC, analyzes major proposals of the 2026 Inpatient Prospective Payment System (IPPS) proposed rule. This webinar is an edited version of the full, 60-minute program.

CPT Coding for Emergency Department and Critical Care

Fri, 06/06/2025 - 09:02
Webinars
Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Hamilton Lempert, MD, CEDC, shares tips on correct CPT coding for emergency department and critical care services.

Please note that CEUs are not available for this program.

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