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.
Reader's Question: Go Ahead and Bill EEG With Hospital Visit
Question: Medicare denied our bill for an EEG when our physician read one in addition to a hospital visit. Can you please provide guidance for the best coding approach?
Florida Subscriber
Answer: Yes, you can report an EEG reading with a hospital visit.
The NCCI currently has no bundling edits between the electroencephalogram codes and the initial or subsequent hospital care E/M codes. Medicare, however, does cover the diagnostic testing services provided in a facility setting, such as a hospital POS (Place of service) 21, as separate components.
Note that the technical component of diagnostic testing is included in...
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