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.
Reimbursement: Think Twice About Billing Infrared Therapy Treatments
Heed what CMS says about reimbursing 97026.
Providers with some therapy clinics tend to lean toward using infrared therapy to treat patients with diabetic neuropathy (357.2, Polyneuropathy in diabetes), but keep one thing in mind before submitting those claims: CMS doesn’t take the same stance.
After going without a finalized national coverage determination (NCD) for quite some time, now infrared therapy is clearly a non-reimbursable treatment, Medicare says.
Clear Up Coverage Confusion
This national coverage determination might seem to contradict what you have heard in the past. For example, a lot of miscommunication has been floating around...
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