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
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AHA Coding Clinic® for HCPCS - 2005 Issue 1; FOR your INFORMATION
Modification of dosage descriptors for certain drugs and biologicals
The Centers for Medicare and Medicaid Services (CMS) is strongly urging hospitals to report all drugs, biologicals, and radiopharmaceuticals, regardless of whether the items are packaged or paid separately, using the correct HCPCS codes for the items used. Hospitals should also make certain that the reported unit of service is consistent with the quantity of a drug, biological, or radiopharmaceutical that was actually administered to the patient.
The HCPCS code descriptors for several HCPCS codes for drugs and biologicals were modified by CMS for 2005. Hospitals should make note of the modifications (bolded) listed below:
Old HCPCSOld Long DescriptorNew...
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