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.
tci General Surgery Coding Alert - 2003 Issue 4
Reader Question: New NPP Rules Affect Hospital,Not Office,E/Ms
Question: I've heard that CMS issued a memorandum regarding new nonphysician practitioner (NPP) guidelines. Will this affect me?
Illinois SubscriberAnswer: The new regulations mainly affect billing for hospital visits (for example, 99221-99223, Initial hospital care) rather than office visits (such as 99211-99215, Established patient office visit ...). Physicians can now bill E/M hospital services even if the NPPinitiates treatment, provided the doctor visits the patient later that day.
CMS Transmittal 1776 (change request 2321), dated Oct. 27, 2002, states, "when a hospital inpatient/hospital outpatient or emergency department E/M is shared between a physician and an NPP from the same...
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