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Medicare Fee Schedule Webinar Highlights Telemedicine, New Specialty Initiatives - 11/26/2025

In addition to uneven payment news, TMA shared the latest on telemedicine, coding changes, and new initiatives set to launch in 2026 and 2027.

Notify Medicare of Participation Changes by Dec. 31 - 11/25/2025

TMA reminds all physicians to check their Medicare participation information to make sure it is current. Those changing their status in 2026 will need to send notification via mail.

Medicare’s Quality Payment Program Won’t Support Internet Explorer 11 - 11/24/2025

Due to security concerns, Medicare’s Quality Payment Program (QPP) will no longer support the Internet Explorer (IE) 11 browser beginning on Oct. 13, the Centers for Medicare & Medicaid Services (CMS) has announced.

How to Set a Standard Fee Schedule for Your Practice - 11/13/2025

 You have complete authority and responsibility to set your own standard practice prices. When you set your fees, consider basic business principles, including profit, return on investment, competition, and marketing.  

Practice E-Tips on Billing and Collections - 11/13/2025

Practice E-Tips on Billing and Collections

Filing a Compliant With the Texas Department of Insurance (TDI) - 11/13/2025

Filing a Compliant With the Texas Department of Insurance (TDI)

Medicare Proposal Offers More Flexibility for ACOs - 11/13/2025

A proposed regulation from the Centers for Medicare and Medicaid Services (CMS) would give certain accountable care organizations (ACOs) leeway to move at their own pace in graduating through the different levels of the Medicare Shared Savings Program, and the Texas Medical Association wants to ensure that flexibility sticks.

Physicians Must Refund Medicare Overpayments Voluntarily, Program Administrator Cautions - 11/13/2025

Novitas, Texas’ Medicare administrator, reminds physicians they should promptly bring incorrect payments to its attention. TMA can assist physicians with payment issues through its Physician Payment Resource Center.

Now Is the Time: Texas Delegates to AMA Make a Strong Push for Fixing What Ails Medicare - 11/13/2025

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.

New Medicaid Managed Care Laws Lauded as Wins for Texas Patients - 11/10/2025

Medicaid captured the Texas Legislature’s attention during the 2025 session, with lawmakers passing a quartet of bills focused on improving managed care statewide, including nutrition and newborn support, physician enrollment, and credentialing.

Medicaid Mindfulness: New Texas Law Raises Certain Violations to Same Level as Intentional Fraud - 11/07/2025

Senate Bill 1038 provides a key state agency with a new array of penalties, signaling the state’s focus on safeguarding Medicaid spending. In the process, however, it has elevated potential penalties for unknowingly violating Medicaid program rules to the same level as those for intentional fraud. 

Medicare Physician Fee Schedule Retains Payment Increase and Concerning Cuts - 11/06/2025

A new practice efficiency cut impacting thousands of codes and a cut targeting hospital-based services could offset a one-time payment boost. TMA staff are poring over the 1,216-page final rule ahead of its Nov. 20 webinar, free for physicians.

Learn Medicare Payment Updates, Earn CME in Live TMA Webinar - 10/31/2025

TMA’s first live Medicare webinar in six years will also address changes to quality and alternative payment programs, as well as a new pilot testing AI in prior authorization. Register now and submit questions in advance.

Medicare to Test Enhanced Technology Utilization Review in Texas - 10/30/2025

The Wasteful and Inappropriate Service Reduction (WISeR) Model is set to debut in Texas and five other states in January 2026. It would require certain Medicare services to undergo “enhanced technology” review.

Government Shutdown: Medicare Continues to Pay Claims for Unexpired Services - 10/27/2025

As of Oct. 15, “no payments have been delayed,” the Centers for Medicare & Medicaid Services said, clarifying a previous notice suggesting a claims hold. Expired provisions continue to include telehealth services.

Appealing Claims Can Have Appealing Results - 10/24/2025

Not appealing inappropriately paid or denied health plan claims can be quite costly to your practice. Here’s why.

Medicare as Secondary Payer - 10/24/2025

Medicare as secondary payer: Submit the primary EOB with paper claims but not with electronic claims.

You Can Get Paid for Medicaid Emergency Services - 10/24/2025

You Can Get Paid for Medicaid Emergency Services

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 Reimbursement - 10/22/2025

Billing & Fees Claims Coding & Documentation Collections Copayments & Deductibles Medicaid & Medicare Workers' Comp Billing & Fees Are You Missing Out on Your Money?    Billi

HHSC Extends Medicaid Revalidation Another Six Months - 10/21/2025

The state is providing physicians with additional time to take a key step in caring for Medicaid patients. It’s also providing a reentry pathway for physicians disenrolled last year.

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

Appeals Appealing Claims Can Have Appealing Results   Claim Forms Multiple Place-of-Service Codes on a Single 1500 Claim Form   Fees New Laws Require Billing Di

Federal Changes May Narrow Certain Medicaid Eligibility Provisions, Boost Others - 10/17/2025

Changes on the horizon include a shortened timetable for giving new Medicaid applicants retroactive coverage, more frequent eligibility checks, and an expansion of the populations eligible for home and community-based services. Texas will also need to reconcile an issue concerning CHIP waiting periods and benefit caps.

CMS Details New Federal Prior Auth Program in AMA Webinar - 10/15/2025

Join leaders from the Centers for Medicare and Medicaid Services’ (CMS’) Center for Medicare & Medicaid Innovation (CMMI) and the American Medical Association on Oct. 22 at 7 pm CT in discussing the Wasteful and Inappropriate Service Reduction (WISeR) pilot, which will test new prior authorization processes for select services in the Medicare fee-for-service program in Texas and five other states.

TMA Monitors Government Shutdown: What You Need to Know - 10/03/2025

TMA is in regular communication with federal colleagues at the American Medical Association on the impact to physician practices, as AMA remains in touch with senior officials at the Centers for Medicare & Medicaid Services.