Key Takeaways on CMS Final Rule 2026 The Centers for Medicare & Medicaid Services (CMS) announced its CMS final rule 2026 policy changes for the Medicare Physician Fee Schedule (PFS) on October 31, 2025.1 Actual changes go into effect on or after January 1, 2026. Other recent regulatory changes are also finalized. Changes that will […]
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Key Takeaways: What Are RVUs in Healthcare RVUs stands for Relative Value Units. RVUs in healthcare are non-monetary units used to quantify the value of medical services. RVUs reflect the relative amount of work, practice expense, and malpractice risk used to deliver different procedures or services. Each service or procedure provided is assigned an RVU
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Key Takeaways to Maximize RHC Reimbursements In 2023, hospitals absorbed $130 billion in Medicare and Medicaid underpayments — a roughly 14% annual increase over 2019.1 And underpayments are one reason providers can benefit from knowing how to maximize reimbursements for rural health clinics (RHCs). Why? Because a higher portion of RHC payments come from public sources compared
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Key Takeaways for the G2211 Procedure Code Last updated December 9, 2025 Procedure code G2211 is a Medicare-specific billing code used as an add-on to codes for standard office, home, or telehealth outpatient and management (E/M) visits. It recognizes the complexity providers face in managing complex conditions and ongoing care needs. In this article, I
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Last updated November 2025 Providers forced to jump through hoops to get prior authorizations for patients know the pain of waiting. But, according to AHIP, prior authorizations ensure a patient gets safe, timely, evidence-based care that’s both affordable and efficient. To help providers ensure patients get that, try the tips in this prior authorization cheat
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Key Takeaways for Fee-for-Service vs Value-Based Care The Centers for Medicare & Medicaid Services (CMS) aims to move Medicare users from a Medicare fee-for-service model and most Medicaid users to a value-based care model by 2030. The goal reflects a broader shift in the healthcare industry, as providers, payers, and policymakers move away from traditional
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Key Takeaways to Prevent Revenue Leaks in RCM In the healthcare landscape — especially for rural and independent ambulatory clinics — every dollar matters. And your financial performance depends on those dollars. But many practices unknowingly lose thousands of dollars due to preventable gaps in their medical billing RCM (revenue cycle management) process. If your
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Running a rural health clinic (RHC) isn’t just about providing quality care — it’s also about keeping your clinic financially healthy and compliant with ever-changing regulations. Between financial reporting, performance metrics, and data analytics, there’s a lot to juggle. But when done right, these elements can help your practice stay sustainable and continue delivering essential
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Key Takeaways on AI Usage in Healthcare Benefits & Use Cases AI technology is steadily revolutionizing industries, and healthcare is no exception. While traditional AI systems have provided valuable insights over the past decade, the emergence of AI agents is ushering in a new era of healthcare automation and efficiency. These technologies don’t just answer
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Key Takeaways on How AI Agents Work in Healthcare Artificial intelligence (AI) is no longer just a futuristic concept—it’s actively transforming healthcare as we know it. From optimizing clinical workflows to enhancing revenue cycle management, AI is paving the way for more efficient and accessible care. One of the most advanced developments in this space
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