Welcome to the StreamlineMD Blog
Welcome to StreamlineMD's official blog page, your go-to resource for insightful information and cutting-edge updates to help Radiology and Interventional Specialists prosper.
Prior Authorization for Interventional Radiology Procedures
Prior authorizations for Interventional Radiology (IR) procedures remains unpredictable. Payers frequently outsource reviews to TPAs such as eviCore, AIM, or Carelon – often switching without notice. Rules vary by plan, and reviewers are often non-specialists.
Cigna Temporarily Pauses Its E/M Coding and Accuracy Policy (R49)
Cigna has announced a temporary pause to the implementation of its Evaluation and Management (E/M) Coding and Accuracy Policy (R49), which was initially scheduled to take effect on October 1, 2025.
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.
Y90 Billing in the OBL: Navigating the Maze of Dose Reimbursement
Billing for Yttrium-90 (Y90) radioembolization procedures in an Office-Based Lab (OBL) is one of the most complex challenges in interventional radiology revenue cycle management. There is no one-size-fits-all answer.
Radiologists: RUC Surveys Open for New & Revised CPT Codes
RUC Surveys are now open for new & revised CPT codes – Radiologists, your input is very important! The American College of Radiology (ACR) is currently gathering physician work data through RUC surveys to help determine the relative value of several radiology procedures.
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.
CPT 2026: Major Radiology & Interventional Coding Updates
Coming soon – CPT 2026: Major Radiology & Interventional Coding Updates. The 2026 CPT code set includes the most extensive Radiology and Interventional coding updates in years. These CPT code updates will significantly impact clinical documentation, coding workflows, and billing systems.
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
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.
Prior Authorization for Interventional Radiology Procedures
Prior authorizations for Interventional Radiology (IR) procedures remains unpredictable. Payers frequently outsource reviews to TPAs such as eviCore, AIM, or Carelon – often switching without notice. Rules vary by plan, and reviewers are often non-specialists.
Cigna Temporarily Pauses Its E/M Coding and Accuracy Policy (R49)
Cigna has announced a temporary pause to the implementation of its Evaluation and Management (E/M) Coding and Accuracy Policy (R49), which was initially scheduled to take effect on October 1, 2025.
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.
Y90 Billing in the OBL: Navigating the Maze of Dose Reimbursement
Billing for Yttrium-90 (Y90) radioembolization procedures in an Office-Based Lab (OBL) is one of the most complex challenges in interventional radiology revenue cycle management. There is no one-size-fits-all answer.
Radiologists: RUC Surveys Open for New & Revised CPT Codes
RUC Surveys are now open for new & revised CPT codes – Radiologists, your input is very important! The American College of Radiology (ACR) is currently gathering physician work data through RUC surveys to help determine the relative value of several radiology procedures.
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.
CPT 2026: Major Radiology & Interventional Coding Updates
Coming soon – CPT 2026: Major Radiology & Interventional Coding Updates. The 2026 CPT code set includes the most extensive Radiology and Interventional coding updates in years. These CPT code updates will significantly impact clinical documentation, coding workflows, and billing systems.
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
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.
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