Learn how to navigate potential payment hurdles when dealing with Medicaid, Medicare and private payer insurance companies.
Telehealth Payment Update
On December 21, 2024, Congress passed H.R.10545 - American Relief Act, 2025, which extends telehealth flexibilities through March 31, 2025. For Medicare payments, including audio only services, physicians should continue to use existing codes with modifier -95. While these codes are likely consistent for private payers, they may vary. We recommend contacting payers directly to confirm any updates or changes. We are actively monitoring this issue and will provide updates as needed.Medicare
Resources to ensure you are paid appropriately, including web-based educational tools and how to bill for an annual wellness visit. Also find information pertaining to the Quality Payment Program, including deadlines.
Medicaid
Learn more about the Medicaid and CHIP programs, both at the federal level and in your own state.
Private Payers Insurance
Materials to help you navigate a variety of issues specific to private payer insurance plans, including details in a standard payer contract and advice on how to retain lab testing when your payer is refusing coverage.
Alternative Delivery and Payment Models
A broad array of resources covering Patient-Centered Medical Home, Accountable Care Organizations, other care models,the CMS Innovation Grant process, and how to evaluate payment contracts.