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: Nebulizer Payment Revisions Demand Proof Of Medical Necessity
Providers: Don't miss the draft LCD--and a chance to comment.Providers who bill Medicare for nebulizer equipment, related supplies or drugs will need to be ready with proof of medical necessity.The Centers for Medicare & Medicaid Services recently assigned the new durable medical equipment Program Safeguard Contractors the task of revamping Medicare's nebulizer-related payment policies.
And the PSCs have delivered--they recently issued a hefty 23 pages outlining future coverage.The changes are significant departures from current policy, reports respiratory therapist Harold Davis, a specialist for The VGM Group's respiratory division in McRae, AR.The local coverage determination includes...
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