Experts share tips for building & managing a profitable rheumatology infusion practice, from staffing & billing to inventory & drug costs.
ACR Leads Sign-on Letter to Cigna Opposing Downcoding of E/M Claims
The ACR recently led a rheumatology community letter to Cigna opposing the payer’s decision to downcode level 4 and 5 evaluation and management claims.
ACR Advocates for Fair Reimbursement & Telehealth Flexibility in MPFS 2026 Proposed Rule
In comments to the CMS, the ACR advocated for telehealth flexibilities and fair reimbursement and pushed back on proposed efficiency adjustments and changes likely to increase administrative burden on practices.
New Diagnostic Code R76.81 Can Be Used to Identify Those at Risk of Developing RA
New ICD-10-CM code R76.81 can now be used for patients who have abnormal rheumatoid arthritis (RA)-related autoantibodies—but not RA—to improve early disease risk identification, preventive care and research.
ACR Responds to Cigna Downcoding of Evaluation & Management Codes
The ACR recently sent a letter to Cigna opposing its new policy, which would result in downcoding of level 4 and 5 evaluation and management claims.
Featured Member Resource: ACR Coding Lunch & Learns
The ACR offers a variety of coding-focused Lunch-and-Learn sessions designed to help physicians and their staff stay current with evolving healthcare regulations, coding updates and billing practices.
CMS to Implement AI-Based Model to Streamline Prior Authorization
Last week, the Centers for Medicare & Medicaid Services (CMS) announced that it is implementing a new prior authorization model called the Wasteful and Inappropriate Services Reduction (WISeR) Model. This six-year model, starting on Jan. 1, 2026, aims to reduce fraud, waste and abuse in traditional Medicare by using technology-enabled processes for prior authorization and…
Stay Current on Coding Guidelines with ACR Lunch-and-Learns
Available topics include CPT telemedicine code sets, G2211 coding updates, evolving HIPAA guidelines, evaluation and management (E/M) coding and billing strategies.
Key Telemedicine Updates for 2025
As of Jan. 1, rheumatology practices face significant changes in coding and reimbursement for telemedicine services, including new and deleted billing codes, updated Medicare policies and looming expiration of pandemic-related flexibilities.
Billing and Coding Updates for G2211 in 2025
On Nov. 1, the Centers for Medicare & Medicaid Services finalized its proposal for an incremental expansion of the G2211 add-on code for complexity.
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