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Court Decides Patients Don’t Have the Right to Ambient AI Recordings

A Washington judge says exam room audio is for administrative purposes only. In one of the first legal rulings on the subject in the U.S., a Washington trial court judge has found that ambient clinical audio recordings that physicians use to help crea...
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AI graphic

COVID-19 Vaccine Pricing for 2026-2027

National payment allowances for COVID-19 vaccines given during the 2026-2027 season are now available. The Centers for Medicare & Medicaid Services (CMS) released the update on Sept. 1. Prices for the following COVID-19 vaccines are effective Aug...
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COVID-19

Operationalizing the Maternity Care Restructuring: Closing the 2026 Revenue Gap

If your obstetrics and gynecology (ob-gyn) team is treating the CPT® 2027 maternity restructure as a January code update, you are already behind. The coding change is real, and it is large. Effective Jan. 1, 2027, the CPT Editorial Panel’s maternity c...
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maternity

Medicare Adds Coverage to Colorectal Cancer Screening NCD

Effective June 8, 2026, non-invasive biomarker screening tests are a covered modality for colorectal cancer (CRC) screening under Medicare. The Centers for Medicare & Medicaid Services (CMS) updated national coverage determination (NCD) 210.3: Co...
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CRC

Why Healthcare Organizations Need CPC-M™ Coders Now

The business of healthcare is rapidly changing, and artificial intelligence (AI) is only making things more complicated. Remember what it was like to implement electronic health records? That was cake compared to what AI will take to standardize. To n...
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CPC-M

I Am AAPC: Megan Smotherman, CPC

At 36 years old, I am many things — but the role I am most proud of is being a mother to two beautiful daughters. Motherhood has given me the greatest sense of purpose I have ever known. Becoming a wife and a mother was always my lifelong dream, and ...
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Megan Smotherman

The Villages Health System Agrees to $541.5M Settlement

The settlement resolves self-disclosed allegations that unsupported diagnosis codes increased MA payments and violated the False Claims Act. The Villages Health System LLC (The Villages), a healthcare provider group headquartered in The Villages, Flor...
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false claims act

Changes to Appendix S Clarify AI Use

Laboratory and pathology diagnostics, processes, and valuations are not immune to artificial intelligence (AI). Upcoming modifications to CPT® AI nomenclature and proposed Medicare payment changes could impact your lab. Appendix S doesn’t contain a ...
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AI

AMA Revises CPT® Category III Early Release Schedule

The American Medical Association (AMA) has changed its early release schedule for CPT® Category III codes to three updates per year instead of two. As a result, the codes that were released in July will become effective three months earlier than usua...
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CPT Category III

RPM/RTM Reimbursement Rules Could Change in 2027

On July 16, 2026, the Centers for Medicare & Medicaid Services (CMS) published its calendar year (CY) 2027 Medicare Physician Fee Schedule (MPFS) proposed rule in the Federal Register. Among the 716 pages are significant proposed changes to remot...
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