Three significant changes that will affect reimbursement rates go into effect January 1, 2026:
Conversion factor changes
Relative Value Unit (RVU) efficiency adjustment
Practice Expense changes
If you're a Find-A-Code subscriber, there's no need to worry. Find-A-Code's fee calculators are ready for the change. You can count on Find-A-Code for the most complete and accurate information you need as a medical coder/biller.
CMS: RACs can't override LCDs unless decision is in your favor
Your Recovery Audit Contractor (RAC) can't disregard the coverage conditions in your local coverage determinations (LCDs) to demand overpayments on any claim in a complex review, CMS officials say. If a RAC believes you should've been paid for a service despite a relevant LCD saying otherwise, it has the power to override the LCD and approve the claim,
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