Related Stories

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.

CMS Announces Latest Scores for Quality Payment Program - 06/23/2025

The Medicare Quality Payment Program will award a slightly higher percentage of positive payment adjustments in 2025 compared to 2024. However, the maximum will be considerably lower than last year’s.

Now is the Time: Texas Delegates to AMA Make a Strong Push for Fixing What Ails Medicare - 06/23/2025

Texas Medical Association members made their voices heard at the American Medical Association’s three-day National Advocacy Conference (NAC), Feb. 10-12, 2025, calling for a long-term Medicare payment fix.

Multiple Choice: How Two APMs Are Contributing to Cost-Conscious Health Care - 06/17/2025

The Medicare Shared Savings Program and ACO REACH program provide physicians with two viable payment models incentivizing better patient care outcomes.

TMA Vigilant of New Medicare Advantage Audits - 06/17/2025

The Centers for Medicare and Medicaid Services has begun what the agency itself calls an “aggressive” new strategy to audit all Medicare Advantage plans annually to review whether insurers and their networks are inflating patients’ illnesses, leading to overpayments – and the additional compliance burdens and possible repayments could fall on physicians.  

Who Can Do the Face-to-Face Encounter for Home Health? - 06/12/2025

Medicare won’t pay home health agencies to care for Medicare patients without a physician’s certification, which must include a face-to-face encounter with the patient. Here’s who can perform that encounter.

Preview Your Medicare Clinician Profile Through June 25 - 05/29/2025

Physicians participating in the Quality Payment Program will see their 2023 performance scores showcased on two publicly accessible websites. One of those will also feature star ratings in up to 17 categories including preventive health and patient safety.

MedPAC Calls for Tying Medicare Payment to Inflation with a Permanent Update - 04/22/2025

The agency advising Congress on Medicare issues calls for a physician payment structure tied to the Medical Economic Index, in line with TMA advocacy. The recommendation calls for a permanent payment update in 2026 and beyond.

Medicine Backs New Legislation Halting Latest Medicare Payment Cut - 04/14/2025

Led by physician lawmakers, the proposed legislation would cancel the most recent physician pay cut and provide some extenuating relief for the remainder of the year. TMA recently joined the American Medical Association’s national advocacy conference to take their efforts to lawmakers’ doorsteps in D.C.

CMS Issues New MIPS Hardship, Extension Tied to IV Fluid Shortage - 03/28/2025

The 15-day window opens today, March 31, and comes in response to medicine’s advocacy. TMA encourages affected physicians to document those shortages and the impact on their practices.

UPDATE: Submit 2024 MIPS Data by April 14 to Avoid 9% Pay Cut - 03/28/2025

The data submission period for Medicare’s 2024 Merit-Based Incentive Payment System (MIPS) performance year is underway and closes on April 14 at 7 pm CT. At stake is a pay cut of up to 9% in the 2026 payment year.

Congress Extends Medicare Telehealth Flexibilities for Another Six Months - 03/24/2025

Several pandemic-era Medicare telehealth and payment flexibilities will now last through Sept. 30 following recent action by Congress, including those that waive geographic site restrictions for mental health telemedicine services provided without an in-person visit.

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?

Advancing Primary Care: Medicare Rolls Out New Payment Codes for Treating Chronic Conditions - 03/04/2025

Though the Centers for Medicare & Medicaid Services (CMS) has introduced another acronym into the Medicare mix, some physicians express optimism this particular one could help practices stay viable.   For Greg Fuller,

Without Congressional Action, Medicare Telehealth Waivers Will End March 31 - 02/26/2025

Medicare telehealth waivers previously extended by Congress will expire March 31, meaning Medicare patients will no longer be able to have telemedicine visits while in their home and physicians will again be required to meet with patients in-person before a telemedicine mental health consultation.

Medicare Payment Cuts Drive Physician Shortage, TMA Tells AARP - 02/24/2025

After an AARP Bulletin article connected the current physician shortage to a wider health care crisis, TMA joined the Physicians Advocacy Institute to co-author a response focusing on the role that Medicare payment cuts play.

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.

Check Eligibility for Medicare Bonus Following Annual HPSA Update - 01/28/2025

Physicians, including psychiatrists, can receive a 10% quarterly bonus from CMS for providing primary care or mental health services to Medicare patients in qualifying areas, with some important distinctions on services rendered.

Congress Extends Medicare Telehealth Waivers, Payment for Audio-Only Visits - 01/10/2025

With telehealth extensions granted under the American Relief Act, TMA has updated its telehealth waiver chart to reflect these temporary changes that allow physicians to provide telemedicine mental health services without conducting an in-person patient visit. The flexibilities were extended through March.

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.

Congress Averts Shutdown, Still Cuts Medicare Payment for 2025 - 01/06/2025

The American Relief Act of 2025, signed into law by President Biden Saturday morning, will extend funding for the government until mid-March. Congress was unable to include several of the Texas Medical Association’s federal goals as the new piece of legislation will not avert the 2.8% cut in Medicare physician payments that will start on Jan. 1, 2025.

Medicare Premiums, Deductibles to Increase in 2025 - 11/12/2024

Medicare patients will be paying more for their coverage in 2025, which will impact how much co-pay practices collect. The rise in patient costs comes at a time when Medicare physician payments still decline and payments to hospitals and other Medicare entities increase.

Feds’ Response to Cyberattack Aids Physicians, But Further Measures Needed - 11/07/2024

Eligible physician practices and others impacted by the recent cyberattack on Change Healthcare now may apply for accelerated and advanced payments for certain Medicare and Medicaid claims.

Medicare Social Media Graphics - 11/06/2024

Once again, physicians’ Medicare payments are set to be cut, this time a 2.8% reduction in 2025. Please download the graphics and post them on your social media channels to raise awareness about the problem.