In 2025, CMS finalized a 2.9% pay increase for hospital outpatient and ASC services, based on a 3.4% market update, minus a 0.5% productivity adjustment. Several major insurance companies are following suit, also steering volume toward the outpatient setting, as…
ASC Coding, Billing & Collections
A physician in Frisco Texas has agreed to pay $3.5 million to resolve claims he violated the knowingly submitting or causing the submission of false claims for evaluation and management services that were not performed, the Justice Department said in…
Elevance Health, parent company of Blue Cross Blue Shield of Georgia, has filed a lawsuit against billing company HaloMD and two physician groups accusing them of exploiting the federal arbitration system established under the No Surprises Act, according to court…
A Kansas City, Mo.-based man has pleaded guilty to a Medicare fraud scheme involving false claims for cancer genetic testing and cardiovascular genetic testing, the Justice Department said in a May 29 news release. What happened? What’s next?
The Trump administration recently issued a request for information seeking input on how to improve drug price transparency, alongside other initiatives aimed at increasing price transparency in healthcare. Here are five updates on price transparency: 1. HHS, the Labor Department…
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In its 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule, CMS made major changes to its reimbursement framework, which is reshaping how ASCs operate and bill, according to a blog post from billing company…
A Slidell, La., physician has pleaded guilty to conspiracy to commit healthcare fraud in a scheme to bill Medicare for medically unnecessary tests, the Justice Department said in a May 27 news release. What happened?
Physician practice owners can earn vastly different salaries depending on several key factors, according to a recent report from Physician’s Thrive. According to the report, independent practice compensation ranges from as low as $53,500 to as high as $370,000, with…
Here are four updates on prior authorization for ASC leaders and physicians to know, as reported by Becker’s so far in 2025:
A physician in Mission, Texas, was sentenced to 10 years in prison followed by three years of supervised release for carrying out a healthcare fraud scheme involving more than $118 million in false claims. Jorge Zamora-Quezada, MD, falsely diagnosed his…