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Medicare Advantage Prior Auth 72-Hour Deemed Approval Rule
By Danish William ·
CMS-0057-F is federal law. Starting January 1, 2026, Medicare Advantage organizations must send prior authorization decisions within 72 hours for expedited requests and seven calendar…
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Billing G0552 DMHT Devices: The 2025 Compliance Playbook
By Eman Zahra ·
CMS opened a new revenue channel for behavioral health practices on January 1, 2025. Three HCPCS codes—G0552, G0553, and G0554—now formally reimburse digital mental health…
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How to Build a FHIR ePA Workflow for Prior Auth in 2026
By Sarah Callahan ·
CMS-0057-F landed in the Federal Register on February 8, 2024, and its January 1, 2026 enforcement deadline has already divided healthcare revenue cycle operations into…
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Offsetting 2026 Medicare Facility PE Cuts: A Billing Guide
By Sarah Callahan ·
Congress passed a one-time 2.5 percent base pay bump for 2026. CMS quietly blunted it with a structural cut that most practices did not fully…