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Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
MIPS 2025 Submission Is Open: A Twelve-Week Plan to Get Data In Before March 31
The 2025 MIPS performance year submission window opened January 2 and closes March 31, 2026 at 8 p.m. Eastern. Here is how we sequence the work: eligibility checks, quality measure completeness, promoting interoperability attestations and improvement activities.
ACA Credits End December 31 and MA Plans Close: Patient Outreach Before January
Unless Congress acts, the enhanced marketplace premium tax credits expire on December 31, 2025, and millions of Medicare Advantage members are in plans that end the same day. Both mean coverage changes at your front desk in January. Here is the outreach plan the practices we work with are running now.
MIPS 2026 Final Policies: The 75-Point Threshold Stays and Six New MVPs Arrive
The 2026 Quality Payment Program policies were finalized with the Physician Fee Schedule on October 31, 2025. The performance threshold stays at 75 points through 2028, six new MVPs arrive, and traditional MIPS survives for now. Here is what to decide before January and what the 2025 submission window looks like.
FY2026 ICD-10-CM Update: 487 New Codes and Where Coders Will Get Them Wrong
The FY2026 ICD-10-CM code set took effect on October 1, 2025 with 487 new codes, 38 revisions and 28 deletions. Here is what changed, the chapters that matter for office practices, and the workflow mistakes that turn a code update into a denial spike.
MIPS 2025 Midyear Checkpoint: Eligibility, PI Window and Quality Completeness
The 2025 MIPS performance year has a 75-point threshold and a penalty of up to 9 percent on 2027 Medicare payments. Late July is the last realistic moment to fix eligibility, Promoting Interoperability and quality data problems. Here is the checklist we run with practices.
Building a Monthly RCM Scorecard: The Twelve Numbers and Where to Pull Them
A monthly revenue cycle scorecard is one page, twelve numbers, the same definitions every month, and a name next to each. Here is the list we use, the formula for each, where the data comes from, the ranges that suggest a problem, a sample page, and the mistakes that make scorecards useless.
MIPS 2024 Data Submission Closes March 31, 2025: A Last-Month Checklist
The 2024 MIPS performance year submission window closes March 31, 2025 at 8 p.m. Eastern, and a missed submission can mean a payment cut of up to 9 percent on 2026 Medicare Part B claims. Here is how we work through the last four weeks without surprises, including what small practices get automatically.
PCMH Annual Reporting for 2025: What to Start Collecting This Fall
NCQA's 2025 Annual Reporting requirements change the eCQM list, add HIV measures, require a diversity report and tighten care plan and clinical advice evidence. Here is what changed, what to pull from the EHR now, and the mistakes that turn a routine check-in into a corrective action plan.
CY2025 Physician Fee Schedule Proposed Rule: What the 2.8% Cut Means
CMS released the CY2025 Physician Fee Schedule proposed rule on July 10: a conversion factor of $32.36, down 2.8% from $33.29, new Advanced Primary Care Management codes, and telehealth proposals that depend partly on Congress. Here is what changes, who it affects and how to model it on your own code mix.
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