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Medicare Telehealth Through December 31, 2027: Audio‑Only vs Audio‑Video and Correct POS Billing

Medicare has extended key telehealth flexibilities through December 31, 2027, including continued coverage of both audio‑video and audio‑only telehealth for many services. This blog walks through what that means for providers, with a special focus on audio‑only rules and correct place of service (POS) coding.  Telehealth Flexibilities Extended Through 2027 Through December 31, 2027, Medicare… Continue Reading

Congress Did Not Extend Medicare Telehealth Flexibilities- Now What?

Access to telehealth, greatly expanded during the pandemic, has continued via a series of temporary extensions rather than legislation. The most recent extension expired on September 30, 2025. With the current deadlock and government shutdown, the future is unclear. In short–if you couldn’t do telehealth for Medicare patients before the pandemic, you can’t do it… Continue Reading

Aetna Downcoding Issue for CPT 99214 & 99215

Dear Providers, Claimpower identified an issue where Aetna is reimbursing CPT 99214 and 99215 at a down-coded rate. Under Aetna’s Claim and Code Review Program, these higher-level E/M services are downcoded due to their Evaluation and Management (E&M) Program. What’s Happening? Aetna  partnered with a third-party vendor to review E&M coding. This vendor assesses whether Level 4 and 5… Continue Reading

Understanding Split/Shared Services and Incident to Services

Understanding Incident To and Split Service Billing Across Office, Hospital, and Nursing Home Locations In the complex world of medical billing, understanding the appropriate use of “incident to” and split/shared service billing is crucial for ensuring compliance and maximizing reimbursement. These billing practices are essential for various healthcare settings, including office, hospital, and nursing home… Continue Reading