The most significant overhaul of obstetric billing codes in 30 years takes effect on January 1, 2027 — and OB-GYN practices that wait until December to prepare will be in…
Virginia Medicaid entered 2026 following one of the most significant restructuring events in the state's managed care history. Effective July 1, 2025, the Virginia Department of Medical Assistance Services (DMAS)…
General surgery encompasses one of the broadest procedural footprints in outpatient medicine — from laparoscopic cholecystectomy and appendectomy to hernia repair, bowel resection, skin and soft tissue procedures, and increasingly…
Wisconsin's Medicaid program occupies a unique position in the national landscape. The state is one of a small number that chose not to expand Medicaid under the ACA — but…
Ophthalmology is structurally distinct from every other medical specialty in outpatient billing. It is the only specialty with two parallel office visit code families — the ophthalmology-specific exam codes (92002–92014)…
This is Week 4 of the ClaimsXperts FQHC Billing Series. Week 1 covered the foundational FQHC billing model. Week 2 was a deep dive into the Medicare PPS. Week 3…
Ohio Medicaid entered 2026 in the middle of one of the most ambitious Medicaid redesign efforts in the country. The Ohio Department of Medicaid (ODM) began its Next Generation managed…
Pediatrics is among the highest-volume and most documentation-diverse specialties in outpatient medicine. A single pediatric appointment can include a well-child examination, two or three vaccinations with physician counseling, a developmental…
Michigan Medicaid entered 2026 with two major developments that directly affect how providers bill and credential in the state. First, the MICH (Mi Coordinated Health) program — Michigan's new Highly…
This is Week 3 of the ClaimsXperts FQHC Billing Series. Week 1 covered what an FQHC is and how encounter-based billing works. Week 2 was a deep dive into the…