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Avoid No Surprises Act Penalties: Mid-Year 2025 Update

Recap: What Does the No Surprises Act Cover? Since we are halfway through 2025, the No Surprises Act (NSA) is now being strictly enforced. Last year, the focus was on training and adjusting to the new rules, but this year it is all about enforcing everyone to follow them. The

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The Trends Set to Reshape Behavioral Health Billing in 2025

How we are paid for behavioral health is evolving quickly. In 2025, providers will have to navigate a lot of new codes, policies, and technologies. Demand for mental health and substance use treatment grew during the pandemic. Telehealth visits for care grew from around 1% prior to 2020 to more

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Q3 2025 PLA Code Updates 23 New AMA Lab Tests to Know

Q3 2025 PLA Code Updates: 23 New AMA Lab Tests to Know

Effective July 1, 2025, the AMA released new Proprietary Laboratory Analysis (PLA) codes and made some revisions. There are 23 new PLA code updates (0552U–0574U) approved by the CPT Editorial Panel, one code revised, and six others removed. These changes will be found in CPT 2026 released in October 2025

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What’s Changing in Medicaid under the 2025 Reconciliation Bill

What’s Changing in Medicaid under the 2025 Reconciliation Bill?

Congressional leaders are considering a broad budget proposal known as the 2025 reconciliation bill that would significantly transform federal programs. Among the areas of top concern is Medicaid, the federal health program for low-income adults, older adults, people with disabilities, and many children. Currently, roughly 71 million Americans are on

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MIPS 2025 Timeline Deadlines You Can’t Afford to Miss

MIPS 2025 Timeline: Deadlines You Can’t Afford to Miss

Imagine doing all the right things for patient care and forgetting a simple deadline and losing Medicare payments. The Merit-based Incentive Payment System (MIPS) has a lot of significant dates each year. If you participate in MIPS for 2025, here’s the timeline you need to be aware of. Forgetting a

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Medical Credentialing in 2025: New NCQA Rules You Must Know

Medical Credentialing in 2025: New NCQA Rules You Must Know

Medical credentialing is the pivotal process of checking the credentials, licenses, and background of healthcare providers. In 2025, it will see radical transformations. As healthcare continues to transform further, Medical Credentialing in 2025 will need greater attention, velocity, and active monitoring than ever before. The new regulations this year require

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Value-Based Care in 2025 Lifeline or Liability for Your Practice

Value-Based Care in 2025: Lifeline or Liability for Your Practice?

Imagine running your medical practice in 2025: staff and supply expenses continue to rise, but reimbursement for your services continues to shrink.  That’s the reality of healthcare finance in 2025, and it keeps a lot of physicians anxious about profiting with their practice. Value-based care (VBC) – a system that

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2025-HIPAA-Security-Rule-Final-Warning-for-Private-Practices

2025 HIPAA Security Rule: Final Warning for Private Practices

Why a 2025 HIPAA Security Rule Update? Cyberattacks on healthcare have skyrocketed, leading to the first in-depth HIPAA Security Rule re-write in over a decade. Alone in 2024, breaches affected more than 180 million individuals health information, at an average cost of more than $10 million per incident – more

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July 2025 HCPCS Update These Codes will Cost You a lot

July 2025 HCPCS Update: These Codes will Cost You

Attention SNFs and Medical Billers: Significant Changes Ahead! If you’re an Skilled Nursing Facility (SNF), Medicare is once again altering the rules. There’s a huge July 2025 HCPCS update you can’t afford to miss. Why is this significant?  Apply the wrong code? Your application will be DENIED. Utilizing an outdated

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Future of Telehealth at Risk? Deadline Extended Until September 2025

Introduction Telehealth changed the face of healthcare during the pandemic. Everyone is now waiting to see what happens to telehealth when temporary Medicare rules expire on September 30, 2025. While a recent Congressional action on March 15, 2025, extended the most important telehealth flexibilities up to September 30, 2025, uncertainty

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