Vascular & Wound Care Billing Under the Microscope: How to Stay Audit-Proof in 2025
Medicare’s updated billing policies for lower extremity vascular, wound care, and skin substitutes procedures are bringing new compliance challenges in 2025 and beyond. Vascular and wound care billing is now officially under the microscope of Federal watchdogs.
Navigating CMS Audits: Understanding the Different Types
For healthcare providers, CMS audits can be a daunting reality. Whether it is a RAC audit looking for overpayments, a CERT audit measuring error rates, or a UPIC audit investigating fraud, understanding the differences between these audits is crucial.
GENICULAR ARTERY EMBOLIZATION – REIMBURSEMENT CHALLENGES
The challenges with genicular artery embolization (GAE) reimbursement vary across carriers. Some payers consider this procedure to be experimental and, therefore, partially or fully deny reimbursement for the associated CPT codes.
2025 CPT Changes for Radiology, Interventional & Cardiology Specialists
Newly released 2025 CPT Changes for Radiology, Interventional, and Cardiology Specialists have increased in comparison to the last few years. Make sure your radiology coding, interventional coding, and cardiology coding service teams are current on these changes. StreamlineMD is ready and here to help!
Key Insights on CMS 2025 Final Payment Rules Impacts on Wound Care Providers
The Centers for Medicare & Medicaid Services (CMS) recently released the 2025 final payment rules, which include impacts on wound care. These rules significantly affect the U.S. healthcare system. Below is a summary of the most important provisions in the 2025 Medicare Physician Fee Schedule (MPFS), Hospital Outpatient Prospective Payment System (HOPPS), and Home Health Prospective Payment System (HHPPS).
Telehealth 2025: Congressional Action Needed on CMS Final Rule
On November 1, 2024, CMS released the CY 2025 Medicare Physician Fee Schedule (MPFS) Final Rule, outlining significant changes to telehealth policies effective January 1, 2025. Without Congress’ intervention, these updates could severely limit access to telehealth services for Medicare patients.
FDA Approves New Alternative Standard for MQSA Reporting
On October 29, 2024, the FDA approved Alternative Standard #25 allowing the provider an assessment of “Incomplete: Need additional imaging evaluation” for the follow-up report issued within 30 calendar days of an initial report that received an assessment of “Incomplete: Need prior mammograms for comparison”.
2025 Endovascular & Interventional OBL vs ASC Fee Impact Analysis
In this blog we analyze the 2025 CMS Final Rule’s reimbursement impact on image-guided procedure specialists performing services in Office/OBL (POS 11) and ASC (POS 24) environments.
2025 MPFS: Key Updates on Telehealth and Frequency Limitations
The Centers for Medicare & Medicaid Services (CMS) has proposed significant updates for the 2025 Medicare Physician Fee Schedule (MPFS). Among the most noteworthy are the extensions of telehealth flexibilities and revisions to frequency limitations.
ASC Complexity Codes for Interventional Cardiac Cath Procedures
The following outline highlights the key aspects of Medicare coding and billing for procedures performed in ASCs, particularly focusing on the new complexity codes introduced in 2023 and their impact on 2024 billing.