Related Stories

More Than $3.3 Million Recovered for TMA Practices in 2025 - 02/13/2026

The Physician Payment Resource Center works for physician members with Medicare, Medicaid, major private payers, and other health plans to help address issues that lead to lost revenue from claim payments.

Medicare Modifier 25 Documentation Under Microscope Following Federal Report - 02/04/2026

A recent federal audit focused on Medicare payments for eye injections revealed overwhelmingly high improper payment rates for evaluation and management services billed with modifier 25 usage. TMA provides information on how to help physicians avoid denials.

Here’s Your 2026 Billing and Coding Checklist - 01/16/2026

TMA’s Physician Payment Resource Center works year-round with member physicians and health plans to resolve certain insurance payment issues. They suggest these practical actions you can take at the start of 2026 to keep your billing and collections on track throughout the year.

Cigna Clarifies Terms, Conditions of Its High-Level E/M Downcoding Policy - 12/30/2025

In communication with TMA, Cigna confirmed its policy will not apply to all physicians and those subject to it can request to be removed from the review process under certain circumstances. Nevertheless, the limited scope of the “exemption” could still represent a significant operational and financial challenge for some practices.

When Should We Write Off Large Patient Balances? - 11/12/2025

Is there a formula to calculate the net present value for the balance of a patient’s account compared with a small monthly payoff?

Collection Agency Submittal Do’s and Don’ts - 11/11/2025

Your collection agency has a better shot at success in collecting your past-due accounts if you follow tips for submitting accounts to the agency.

Make Physician Training in Coding Methods Part of Your Practice - 11/10/2025

Increase physician understanding of coding by implementing physician-led coding and compliance programs. 

The X{EPSU} Modifiers Further Define Modifier 59 - 10/24/2025

Modifier 59, the distinct procedural service modifier associated with Medicare National Correct Coding Initiative edits, is one you might find confusing (many practices do). Follow these guidelines

Practice e-Tips on Coding - 10/20/2025

Get practice tips on all things coding. Learn about coding methods, correct coding, resources, coding related to Workers' Comp and more.

Should You Bill This Visit as “Incident to”? - 10/16/2025

A physician hires a nonphysician practitioner and establishes a standing delegation order for a specific course of treatment. … Read the rest of the scenario. Can you answer the billing question correctly?

Timing for Annual Medicare Mammograms - 09/18/2025

Medicare counts 11 full months after the month in which the patient received her screening

Four Bill-Collecting Tips for New (or Any) Practices - 09/16/2025

Starting a practice can be daunting, and one challenge often overlooked is making sure you get paid. Although only a small number of patients will not pay you, or will pay slowly, they can hurt your bottom line. Writing off thousands of dollars in charges should not be an option.

Novitas Clarifies Payment Available for ‘Buildup Phase’ of Allergy Treatments - 09/12/2025

The Medicare administrative contractor confirmed their payment policy at a meeting with TMA. Members should contact the association’s Physician Payment Resource Center if claims denials occur.

Cigna Downcoding Policy Threatens Payment; TMA Urges Repeal - 08/18/2025

The payer announced a new plan under which it may adjust certain higher-level evaluation and management codes based on the encounter criteria in a submitted claim.

How to Improve Patient Debt Collection Practices - 08/06/2025

TMA staff remind physicians that securing insurance information from patients before seeing them is a crucial first step in obtaining payment. They also offer advice on involving office staff and accountants in the process.

VA Seeking Refunds from Physicians for Past CHAMPVA Claims - 06/26/2025

Physicians may soon hear from the U.S. Department of Veterans Affairs (VA) seeking refunds for payments it says were made in error. TMA has provided information on what steps physicians may take.

Service Provider: TMA Practice Resources Educate Physicians on Practice Challenges - 06/23/2025

TMA’s robust practice resources help educate physicians on common billing issues, payer updates, and practice challenges.

Why You Need a Written Payment Policy - 03/19/2025

If your practice is wishy-washy about your payment policy, you essentially are allowing each patient to make his or her own policy. What other business allows its customers to decide when and how they will pay?

Don’t Overlook Credit Card Processing Fees - 02/14/2025

In today’s world of coinsurance and high-deductible health plans, more of a practice’s revenue comes from the patient, and taking credit cards has become a must. But are you paying too much for credit card processing services?

Aetna Reverses NPP Payment Reduction Under Incident-To Billing - 02/12/2025

Aetna previously intended to pay nonphysician practitioners (NPPs) 85% of the allowable amount, regardless of whether they billed directly or “incident-to” a physician’s diagnosis and treatment. Meanwhile, the payer upholds a new credentialing requirement.

Your Billing and Collections Checklist for 2025 - 01/10/2025

TMA’s Reimbursement Services staff work year-round with physicians and health plans to help make sure you get paid correctly and on time. They’ve put together a list of practical actions you can take at the start of 2024 to keep your billing and collections on track throughout the year.

TMA to Represent Texas Physicians’ Coding, Payment Concerns on National Credentialing Organization - 12/17/2024

TMA’s Director of Physician Payment Services has been appointed to the former Academy of Professional Coders’ National Advisory Board, where she will elevate the voices of Texas physicians through collaboration on coding, billing, and compliance issues.

Code Carefully for Bilateral Procedures - 10/02/2024

Coding for bilateral procedures can be confusing. See how payers differ in how they apply CPT modifier 50 to their coding and payment policies.

BCBSTX to Require E/M Codes for Consultation Services - 09/03/2024

Starting Nov. 18, Blue Cross and Blue Shield of Texas will no longer pay physicians for outpatient or inpatient consultations when they report those services with Current Procedural Terminology codes 99242 – 99245 and 99252 – 99255.

Coding with Care: Knowing Billing Codes for Complex Care Can Maximize Revenue, Access to Care - 08/28/2024

Knowing billing codes for complex care can maximize revenue and access to care.