Cigna’s New Reimbursement Policy: E/M Code Downgrades

Beginning October 1, 2025, Cigna will implement a new Evaluation and Management (E/M) reimbursement policy (Policy R49) that allows for the automatic downcoding of high-level E/M services.
Key Diagnostic Radiology, Interventional & ASC MPFS Changes for 2026

This proposal delivers the most extensive set of Diagnostic Radiology, Interventional & ASC MPFS Changes in several years, covering both professional reimbursement and site-of-service adjustments.
Become a Great Radiology & Interventional Radiology Boss: A Simple (But Not Always Easy) Guide (Part 2)

In every thriving company, there’s usually a great boss behind the scenes; someone who leads with purpose, manages with clarity, and creates a workplace where accountability and engagement go hand-in-hand. In the fast-paced world of Radiology & Interventional Radiology practices, that often means building and leading multidisciplinary teams of physicians, APPs, nurses, technologists, and administrators towards a shared goal of sustainable, compliant, and compassionate patient care.
CMS Medicare Advantage Audit Expansion

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced a Medicare Advantage (MA) Audit Expansion.
Interventional Radiology RUC Survey Launch – June 13

The Society of Interventional Radiology (SIR) has announced that RVS Update Committee (RUC) surveys will be sent starting June 13, 2025, to randomly selected SIR members.
Become a Great Radiology & Interventional Practice Boss. A Simple (But Not Always Easy) Guide (Part 1)

In every thriving Radiology & Interventional practice, there’s usually a great boss behind the scenes; someone who leads with purpose, manages with clarity, and creates a workplace where accountability and engagement go hand-in-hand. Becoming a great boss comes down to mastering two key roles: Leadership and Management.
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.
Supply and Demand at the Heart of US Healthcare Crisis

Insights from StreamlineMD CEO Harry Curley on PBS Forum 360 Healthcare costs keep climbing while reimbursements shrink, and many physicians feel caught in an unsustainable squeeze. On a recent episode of PBS’s Forum 360, host Sally Henning sat down with Harry Curley, CEO of StreamlineMD, to unpack the pressures facing US healthcare providers and the innovations that can keep quality […]
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.
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).