Okay, so the whole country is deep in World Cup fever right now — 48 teams, 16 cities, and the final goes down right here on U.S. soil on July 19th at MetLife Stadium. It’s loud, it’s electric, and honestly? The healthcare billing world just got its own version of a penalty shootout. CMS dropped […]
If you have spent any time in healthcare billing, you know that denial codes can quietly drain thousands of dollars from your revenue cycle before anyone notices the pattern. Among the most misunderstood and frequently overlooked is the PR 31 denial code. It shows up on an Explanation of Benefits (EOB) or Remittance Advice (RA),
Good news: the much-talked-about “telehealth cliff” has officially been postponed. On February 3, 2026, the President signed H.R. 7148, the Consolidated Appropriations Act, 2026, extending key Medicare telehealth flexibilities through December 31, 2027. Translation? Your virtual care strategy doesn’t need an emergency landing anytime soon. You’ve got runway—plenty of it. What’s Staying Put The law
The Opening Gift: How the Fee Schedule Works (and Why It Feels Like Secret Santa) Imagine the anticipation every fall: CMS, Congress, medical specialty societies, and every practice across the country are prepping for the big reveal—the Medicare Physician Fee Schedule (MPFS) for the next year. But this isn’t just opening presents. It’s a carefully
When the Calm of Summer Gives Way to Autumn Chaos The easy pace of summer has faded into fall’s familiar rush — lunchboxes packed before dawn, school bells ringing, and inboxes overflowing. For healthcare providers, that same hectic rhythm feels familiar: CMS has announced another delay, extending its hold on telehealth‑related Medicare claims. According to the October 15 MLN Connects Newsletter, CMS directed all Medicare Administrative Contractors (MACs) to continue temporarily
It’s October 2025, and while football fans are glued to unpredictable plays this season, healthcare providers are stuck watching their own kind of gridiron drama — Medicare’s latest “hold everything” game plan. The Play-by-Play CMS has directed Medicare Administrative Contractors to continue holding claims affected by expired payment provisions — that means telehealth, ground ambulance, and FQHC claims are all
Well, folks, here we are—October 2025, and the telehealth roller coaster just took another sharp turn. Congress hit the snooze button, the government is doing its best “out of office” impression, and those cozy pandemic-era telehealth rules officially bid us farewell at midnight on September 30. So, if you were betting on virtual visits being
CMS Proposed rule and what it means for RPM.
Listen up, doctors, suppliers, and anyone billing Medicare for patient care! There’s a new wrinkle in the world of enrollment – the “stay of enrollment.” Don’t worry, it’s not a complete shutdown, but it is a yellow card from Medicare. So, What Exactly is a Stay of Enrollment? Think of it like a temporary hold
Biden administration announces end to Covid-19 Public Health Emergency (PHE) The emergency declarations related to the Covid -19 pandemic will expire on May 11th, according to the Biden administration. “The COVID-19 national emergency and public health emergency (PHE) were declared by the Trump Administration in 2020,” the Office of Management and Budget said in a statement.
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