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What Changed in the 2026 Medicare Physician Fee Schedule for Neurology?
By Eman Zahra ·
CMS finalized two 2026 conversion factors: $33.57 for qualifying APM participants and $33.40 for everyone else, both up from 2025’s $32.35. Beneath that increase sits…
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When to Self-Disclose a Medical Billing Overpayment to OIG
By Sarah Callahan ·
What Is the Real Difference Between an Overpayment and a Reportable Violation? An overpayment is money received in error with no underlying violation of federal…
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Why Billing Staff Now Face FCA Whistleblower Risk in 2026
By Sarah Callahan ·
Billing staff face direct personal exposure because the False Claims Act imposes liability on anyone who “knowingly” submits a false claim, not just the practice…
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RADV Audit V28: Documentation Risk for Physician Practices
By Sarah Callahan ·
A chart-pull letter used to be a rare event. Now it arrives on a schedule. Payment Year 2026 runs entirely on the CMS-HCC V28 model,…
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Virtual Credit Card Medical Billing Fees: 2026 Fix Guide
By Danish William ·
Virtual credit card medical billing fees quietly cost practices thousands of dollars a year, and most billing teams don’t realize they never had to accept…
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WISeR Model Medicare 2026: The Six-State Prior Auth Guide
By Sarah Callahan ·
The WISeR Model Medicare pilot went live January 1, 2026, in six states, and it changes how practices get paid for a narrow list of…
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Cloned EHR Notes: The Audit Risk Practices Miss in 2026
By Sarah Callahan ·
Cloned notes used to mean one physician cutting and pasting a paragraph. In 2026, it means something bigger: templates, macros, and AI scribes all producing…
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TPE Audit Response: A Complete Step-by-Step Survival Guide
By Sarah Callahan ·
The envelope looks routine. It isn’t. A Notice of Review from your Medicare Administrative Contractor means you’ve entered a Targeted Probe and Educate audit, and…
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What Happens After a RAC Audit Letter Hits Your Practice
By Sarah Callahan ·
The envelope looks routine until you open it. Inside sits a Recovery Audit Contractor letter, and your practice now has a clock running. What you…
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CPT 99080 CMS-1500 Offset: Workers’ Comp E-Billing Rules
By Danish William ·
CPT 99080 is a “by report” code originally meant for special reports. New York’s Workers’ Compensation Board repurposed it, capped at $1 per bill, to…