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8 EHR Changes That Could Save Physicians Hours Each Day

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The American Medical Association highlights several simple adjustments practices can make to their electronic health record (EHR) systems that may significantly reduce administrative burden and physician burnout. The recommendations come from the AMA’s STEPS Forward® de-implementation checklist, which focuses on eliminating low-value tasks that do not improve patient care. Key suggested improvements include: According to the AMA, even small workflow changes can free up significant time—allowing physicians to spend more time with patients and less…
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BCBS Michigan Revises Modifier 25 Policy Ahead of May 2026 Implementation

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Blue Cross Blue Shield of Michigan has updated its policy that will reduce reimbursement for certain evaluation and management (E/M) services billed with modifier 25 on the same day as procedures. Beginning May 1, 2026, the insurer plans to reduce payment by 50% for non-preventive E/M services billed with modifier 25 when performed alongside minor procedures with global periods of 0 or 10 days. The payer clarified that 90-day global procedures were mistakenly included in…
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Eli Lilly Introduces Direct-to-Employer Platform for Zepbound Coverage

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Eli Lilly and Company has launched Employer Connect, a new platform designed to give employers a direct pathway to offer coverage for the weight-loss medication Zepbound outside traditional pharmacy benefit structures. Through the platform, employers can work with independent program administrators—such as Calibrate Health, Teladoc Health, GoodRx, and Cost Plus Drugs—to design obesity treatment benefits for employees. Under the program, Zepbound will be available at a list price of $449 per month for all doses…
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Reminder: APP Plus Quality Data Submission Deadline Approaching for ACOs

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The data submission period for Performance Year (PY) 2025 under the Quality Payment Program (QPP) is currently open, with a deadline of March 31, 2026, at 8:00 p.m. ET. Organizations participating in the Medicare Shared Savings Program should review and submit their quality data before the deadline, as updates or corrections will not be accepted once the submission window closes. For PY 2025, Accountable Care Organizations (ACOs) are required to report quality data using the…
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CMS Finalizes HCPCS Level II B2 2025 Coding Updates

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The Centers for Medicare & Medicaid Services (CMS) has released the final determinations for the HCPCS Level II Second Biannual (B2) 2025 coding cycle covering non-drug and non-biological items and services. The update includes new codes, revisions to existing codes, and final decisions on submitted coding applications. These determinations help define how certain items and services are reported, categorized under Medicare benefits, and potentially reimbursed. The CMS publication also outlines each request reviewed during the…
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Flu Remains Major Seasonal Threat as COVID-19 Becomes More Predictable

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Recent reporting highlights that the United States has experienced two consecutive severe flu seasons, while the impact of COVID-19 has become more stable and predictable. Experts note that unlike seasonal influenza—which typically peaks in winter—COVID-19 continues to circulate year-round with occasional summer increases. Recent flu seasons have also been complicated by unusual influenza strains that reduced the effectiveness of annual vaccines, though widespread prior infection and vaccination have helped maintain strong protection against severe COVID…
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Insurers Increasing Scrutiny on E/M Billing Practices

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Modifier 25 Reimbursement ChangesBlue Cross Blue Shield of Michigan plans to reduce reimbursement by 50% for certain office visits billed with modifier 25 when a procedure is performed the same day, beginning May 1. The policy focuses on minor procedures and aims to prevent duplicate payment for evaluation services that may already be included in a procedure’s global period, though some services—such as emergency visits and procedures without a global period—are exempt. Automatic Downcoding PoliciesCigna…
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CDC Report Highlights Rise in KSHV Infections Among Organ Transplant Recipients

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A new report in the Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention highlights a sharp increase in infections linked to Kaposi Sarcoma–associated herpesvirus (KSHV) among U.S. solid organ transplant recipients between 2021 and 2025. During this period, 46 donors were suspected of transmitting the virus—up significantly from previous years—leading to infections in nearly half of the 153 recipients who received organs from those donors, including 25 deaths. Because transplant…
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Study Finds Medicare Add-On Code G2211 Increasing Physician Payments

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A study published in JAMA found that the Medicare add-on billing code G2211 generated about $394 million in payments in 2024, its first year of use, after being billed 26 million times for 10.6 million patients. Although the code was originally intended to support primary care providers managing ongoing or complex patient care, specialists accounted for a large share of usage due to Medicare rules preventing specialty-restricted billing codes. The findings highlight how the code—introduced…
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Medicare Extends No-Pay Summary Notice Mailing Timeline

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Centers for Medicare & Medicaid Services has updated the mailing schedule for No-Pay Medicare Summary Notice (MSN) statements, changing the frequency from every 120 days to every 180 days beginning Jan. 1, 2026. The update applies to notices sent when no claims payments are made during a period, and CMS is also encouraging beneficiaries to opt for digital MSNs to access their notices electronically instead of waiting for mailed statements. Resource: No-Pay Medicare Summary Notice…
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CDC Study Highlights Measles Spread Linked to Air Travel

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Researchers from the Centers for Disease Control and Prevention reported that an unvaccinated traveler who flew from Europe to the United States while infectious with Measles transmitted the virus to 17 additional people, including passengers exposed during flights, at the airport, and through subsequent community spread. The investigation traced 135 exposed travelers, with infections occurring on both international and domestic flights, and several cases requiring hospitalization. The findings highlight the importance of vaccination before international…
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Congress Restores 3.1% Medicare APM Bonus for Physicians

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A provision in the Consolidated Appropriations Act, 2026 restores a 3.1% incentive bonus for physicians participating in Medicare Alternative Payment Models (APMs) for the 2026 performance year. The bonus, which had expired in 2024, was reinstated through the bipartisan funding package passed by Congress and will be paid to eligible physicians in the 2028 payment year, consistent with the payment timeline established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Resource: 3.1%…
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