Federal Government Reopens, Stability for Healthcare Practices Resumes

The restoration of federal funding will keep the government operational through January 30, 2026, while also reinstating and extending a range of healthcare policies that lapsed during the September shutdown.

Key impacts for practices

For practice administrators and physician owners, several takeaways are worth noting:

• Reimbursement holds lifted: The Centers for Medicare & Medicaid Services (CMS) temporarily paused some Medicare claims during the shutdown. With funding restored, most holds have been lifted, but telehealth and hospital-at-home reimbursements could still face scrutiny as regulators catch up.
• Critical Medicare telehealth flexibilities have been extended, such as the removal of geographic and originating site restrictions, the expanded list of practitioners eligible to furnish telehealth services, and more, through January 30, 2026.
• Operational uncertainty continues: The shutdown delayed federal rule-making and budget approvals tied to Medicare payment adjustments. Even with the government reopened, the ripple effects could last into mid-2026, particularly for practices dependent on CMS updates and state Medicaid contracts.

What practices should do now

Independent practices can take several proactive steps to manage the fallout:

• Reassess telehealth compliance. Review services billed after September 30 to ensure they meet current requirements, and use Advance Beneficiary Notices (ABNs) when applicable.
• Monitor reimbursement trends. Track any delays or discrepancies in Medicare Part B and telehealth payments.
• Communicate with staff and patients. Explain any ongoing administrative delays and emphasize continuity of care.
• Engage advocacy partners. Stay connected with professional organizations like MGMA, the American Medical Association and specialty societies for updates on pending legislation.

Contact Yeo & Yeo Medical Billing & Consulting for assistance.

As the healthcare landscape continues to shift, the Centers for Medicare & Medicaid Services (CMS) has issued critical updates that directly impact billing operations. Here’s what medical billing professionals need to know from the latest CMS guidance.

Claims Hold in Effect for Key Medicare Services

CMS has directed all Medicare Administrative Contractors (MACs) to temporarily hold claims with dates of service on or after October 1, 2025, for services affected by expired legislative payment provisions under the Full-Year Continuing Appropriations and Extensions Act, 2025. In light of the continuing government shutdown, CMS will continue to process and pay held claims in a timely manner with the exception of select claims for services impacted by the expired provisions (telehealth claims).

This hold applies to:

• Medicare Physician Fee Schedule (MPFS) claims
• Ground ambulance transport claims
• Federally Qualified Health Center (FQHC) claims

Providers may continue submitting these claims, but payments will not be released until the hold is lifted. This precautionary measure anticipates possible Congressional action that could alter payment structures.

Telehealth Coverage Reverts to Pre-COVID Rules

In the absence of new legislation, pre-pandemic Medicare telehealth restrictions are now reinstated for services not related to behavioral health. Effective October 1, 2025:

• Telehealth services provided in patients’ homes or outside rural areas are no longer covered.
• Hospice recertifications must be conducted in person.

Practitioners offering non-covered telehealth services should consider issuing an Advance Beneficiary Notice of Noncoverage (ABN) to inform patients of potential out-of-pocket costs. CMS provides ABN forms and instructions here.

Providers may also choose to hold telehealth claims that are not payable under current rules while monitoring Congressional developments. For more details, visit the CMS telehealth coverage page.

ACOs Retain Telehealth Flexibility

Clinicians participating in Medicare Shared Savings Program Accountable Care Organizations (ACOs) can continue furnishing and billing for covered telehealth services without geographic restrictions, including services delivered in the patient’s home. No special application is required to access these flexibilities. Learn more in the ACO Telehealth Fact Sheet.

NCCI Edit Revision: COVID-19 Vaccine Billing Correction

CMS has resolved a billing issue that caused denials of CPT code 90480 when submitted with G0008, G0009, or G0010. The error stemmed from a Procedure-to-Procedure edit in the 2025 Q4 National Correct Coding Initiative (NCCI) files.

On October 14, 2025, CMS released updated NCCI files to remove the problematic edit. MACs will automatically reprocess affected claims with service dates between July 1 and October 15, 2025, within approximately 30 business days. Providers do not need to take action unless they prefer to:

• Use the MAC appeals process, or
• Wait to submit impacted claims until after the correction is fully implemented.

Takeaway for Billing Teams

Stay alert to these changes and adjust claim submission strategies accordingly. Whether it’s holding claims, issuing ABNs, or tracking vaccine billing corrections, proactive steps now can prevent payment delays and compliance issues later.

Contact Yeo & Yeo Medical Billing & Consulting for assistance.

Congress failed to agree on a funding bill for fiscal year 2026, resulting in a government shutdown beginning October 1, 2025.

What does this mean for your practice?

1. Medicare reimbursements will continue. Standard Medicare reimbursement processes should continue as normal.
2. Certain telehealth flexibilities will revert to pre-pandemic policies, and the 1.0 work Geographic Practice Cost Index (GPCI) floor has expired – for now. Congress is expected to return this weekend to continue negotiating. There is bipartisan support for both these policies, which could be reinstated in a future funding bill.
3. Most Medicare operations are expected to continue as usual, and the Centers for Medicare and Medicaid Services (CMS) has sufficient funding for Medicaid to fund the first quarter of FY 2026. Activities such as facility survey and certification, policy and rulemaking, contract oversight, and outreach will be reduced or stopped during the shutdown.

What expired:

• Home as an Originating Site – the ability for Medicare beneficiaries to receive telehealth services from their homes.
• Geographic Restrictions – the prior requirement for patients to be in a designated rural area to receive Medicare telehealth services.
• Audio-only Visits – the allowance for audio-only telehealth services for non-behavioral health services.
• Expanded Provider Eligibility – waivers that allowed a broader set of providers (like physical and occupational therapists) to offer services via telehealth.
• Hospital at Home Programs – the waiver authority for Medicare’s ‘Hospital at Home’ program.

What to expect:

• Limited Access to Care – millions of Medicare beneficiaries will face barriers to receiving telehealth care.
• Increased Travel – patients will likely need to travel to a medical facility to receive telehealth services.
• Disruption to Services – providers who rely on telehealth will have to adjust their practices, and some critical programs could face major disruptions.
• Returning ‘Pre-Pandemic’ Rules – Medicare’s coverage will revert to rules that were in place before the COVID-19 public health emergency.

Update from CMS on the federal government shutdown

Please read the CMS’s special notice that provides an update on Medicare operations for claims processing, telehealth, and the status of Medicare Administrative Contractors (MACS) during the government shutdown.

We recommend that you monitor CMS and Department of Health and Human Services updates. These agencies may post contingency plans or guidance on billing, reimbursements, and regulatory changes. Also, prepare for delays in federal program communications, approvals, and audits.

Contact your Yeo & Yeo advisor with questions or for help navigating these changes.

Beginning October 1, 2025, all qualified mental health providers participating in Michigan’s Medicaid program and contracted with Medicaid Health Plans (MHPs) and/or Prepaid Inpatient Health Plans (PIHPs) will need to incorporate into their practice:

• Use of standardized tools to assess the level of mental health need of Comprehensive Health Care Program (CHCP) enrollees seeking mental health services. 
  • MichiCANS Screener for children and youth (under 21)
  • LOCUS tool for adults (21 and older)
• A standardized referral process for mental health services, including the use of a new referral platform.

Training for Standardized Assessments

Training on both tools will be free and is required for staff who complete the assessments, as well as their supervisors.

• LOCUS: Training will be online and self-paced. MDHHS will share the training link when available.
• MichiCANS: Providers must complete the TCOM Training before registering for the Overview Training. Registration instructions are available here.

Beginning in October 2026, MHPs will begin covering additional mental health services for enrollees with lower levels of mental health need. Providers of these services should prepare to contract with MHPs and PIHPs for coverage effective October 1, 2026.  

For more information, visit:

• MDHHS Mental Health Framework
• MichiCANS for CMHSPs and PIHPS FAQ

 Contact your Yeo & Yeo advisor with questions or for help navigating these changes.

An important update from the Council for Affordable Quality Healthcare (CAQH) may impact your providers’ credentialing status.

New requirement from CAQH

CAQH has announced that liability insurance face sheet uploads are now mandatory for all providers. This marks a significant change from previous policy.

• Previously: Uploads were only required during initial CAQH profile setup. Existing profiles only needed the insurance data entered—not the actual document.
• Now: Every provider must upload the face sheet each time liability coverage is renewed, regardless of profile status.

What you need to do

To remain compliant and avoid disruptions in credentialing:

• Ensure each provider’s current liability insurance face sheet is uploaded to their CAQH profile.
• Upload the document immediately upon renewal of coverage.
• Verify that the uploaded face sheet matches the data entered in the profile (policy number, dates, carrier, coverage amounts).

Use the CAQH Provider Data Portal to upload the required documents. Please note that your submission is not complete without the required supporting documentation.

Best practices

• Set calendar reminders for each provider’s insurance renewal date.
• Upload face sheets promptly to avoid status changes.

We’re here to support you through this transition. Please reach out with any questions or concerns.

Starting July 1, 2025, Blue Cross Blue Shield of Michigan and Blue Care Network will require new telemedicine procedure codes (98000–98015) for all virtual evaluation and management (E/M) services.

Here’s what you need to know:

• Use place of service (POS) codes 02 or 10 for telemedicine.
• For virtual visits, do not use traditional in-office E/M codes (*99202–*99205 or 99212–99215). Claims using these codes with a telemedicine place of service or modifier will be denied.
• Modifiers are not required with the new telemedicine codes.

Reimbursement rates for both the new and existing E/M codes are available in the provider portal.

View the full list of new telemedicine codes and read the FAQ

If you have any questions or need help preparing for this change, contact Yeo & Yeo.

Running a medical practice isn’t just about providing excellent patient care—it’s also about managing operations efficiently and maximizing profitability. With rising costs, complex regulations, and administrative burdens, many practices struggle to maintain financial health while delivering high-quality services.

The good news is that by implementing the right strategies, your practice can streamline operations, improve cash flow, and enhance the patient experience—all while boosting your bottom line.

Here are 8 essential tips to help you run a more profitable and efficient medical office.

1. Optimize Your Revenue Cycle Management (RCM)

Efficient RCM is the backbone of a financially healthy practice. Without a well-managed billing and collections process, practices can lose thousands of dollars in unpaid claims. Ensure accurate coding and documentation to prevent denials and regularly review accounts receivable and follow up on outstanding payments.

2. Leverage Automation and AI

Manual processes waste valuable staff time and increase errors. By using automation and artificial intelligence, your practice can eliminate inefficiencies and reduce administrative burdens. Assess your practice’s needs and choose automation tools that will integrate into your current systems.

3. Streamline Office Workflow and Processes

A disorganized office leads to wasted time, frustrated staff, and poor patient experiences. Optimizing office workflow ensures smoother operations and improved efficiency. Standardize processes for check-in, check-out, and documentation, and conduct regular workflow assessments to identify and eliminate bottlenecks in your operations.

4. Improve Patient Scheduling for Maximum Productivity

An inefficient schedule can lead to no-shows, long wait times, and wasted resources. Smart scheduling can help your practice maximize patient volume without overwhelming providers. Consider implementing a patient self-scheduling system that allows for easy rescheduling and appointment reminders.

5. Enhance the Patient Experience to Boost Retention

A positive patient experience directly impacts your practice’s revenue. Happy patients return, refer others, and leave positive reviews, driving new business. Implement a patient feedback system to track satisfaction and improve service quality. This can include follow-up with patients using automated reminders and surveys.

6. Strengthen Financial Management and Cost Control

A profitable practice is not just about increasing revenue—it’s also about controlling costs. Regularly review overhead costs and negotiate better vendor rates, if possible. Working with an accounting professional can also help you uncover hidden savings and boost profitability.

7. Invest in Staff Training and Development

Your staff plays a crucial role in practice efficiency. Investing in ongoing education ensures they are up-to-date on the latest billing, coding, and compliance changes. Provide regular training on new regulations and best practices and encourage cross-training to improve flexibility and efficiency.

8. Consider Outsourcing Non-Core Functions

Outsourcing can reduce operational burdens, cut costs, and improve efficiency. Consider outsourcing medical billing and coding to minimize errors and increase collections, or hire a practice consultant to identify workflow improvements and assess practice management. Outsourcing allows your team to focus on patient care while professionals handle complex administrative tasks.

Unlock Your Practice’s Full Potential

The most successful medical practices don’t just adapt to change—they lead it. Maintaining the status quo isn’t enough in today’s fast-paced healthcare environment. Proactive optimization is key to long-term success—streamlining operations, enhancing technology, and ensuring financial sustainability.

By implementing even a few strategies outlined here, your practice can become more productive, profitable, and future-ready. The key is to start now and commit to ongoing improvement.

Ready to unlock your practice’s full potential? Download our free eBook, The Modern Medical Practice: How to Run a More Profitable and Efficient Office, and gain insights to transform your practice today.

 Download the eBook

President Trump signed a short-term spending bill on Saturday, March 15, extending key telehealth provisions through September 30, 2025. The legislation includes:

• Medicare Telehealth Flexibilities (previously set to expire March 31, 2025):
  • Geographic & Originating Site Restrictions: Medicare beneficiaries can continue receiving telehealth services from any location, including their homes.
  • Expanded Practitioner Eligibility: Physical therapists, occupational therapists, and speech-language pathologists remain eligible to provide telehealth services.
  • FQHCs & RHCs: These facilities can continue serving as distant site telehealth providers.
• Audio-Only Telehealth Services: The authorization for audio-only telehealth services is extended.
• Acute Hospital Care at Home Program: Hospitals can continue providing hospital-level care in patients’ homes.

While these extensions offer temporary relief, the long-term future of telehealth remains uncertain. Now is the time to assess your telehealth strategy and ensure compliance with evolving regulations. Yeo & Yeo Medical Billing & Consulting can help your practice stay prepared and avoid disruptions. Contact us.

Meridian Health Plan has announced a significant policy change that will directly impact medical billing and reimbursement for out-of-network services. Effective May 1, 2025, all out-of-network providers must obtain prior authorization before rendering services to Meridian members.

Key Impacts on Medical Billing:

• Claims Denials & Delays: Claims for out-of-network services without prior authorization may be denied, leading to delayed reimbursements and increased administrative work.
• Billing Workflow Adjustments: Billing teams must coordinate with providers to obtain prior authorization before services are performed, reducing rejected claims.
• Revenue Cycle Management Considerations: Practices that frequently bill Meridian for out-of-network services must adapt their processes to comply with this new requirement to avoid payment disruptions.

Some exclusions apply. For further details, visit Meridian’s official provider bulletin or contact their Provider Services department.

Contact Yeo & Yeo Medical Billing & Consulting for additional guidance on how these changes may impact your practice.

Several changes to telehealth billing and reimbursement policies are coming into effect in 2025, impacting healthcare providers. Here’s a summary of key updates:

1. Telehealth CPT Codes (98000–98016)

• Blue Cross and Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN): Will reimburse CPT codes 98000–98011 beginning January 1, 2025.
• Priority Health: Will reimburse CPT codes 98000–98016 for commercial plans but not for Medicare plans. Medicaid guidance is pending. Additional Priority Health billing guidance can be found here.
• Medicare and Health Alliance Plan (HAP): Only CPT code 98016 is valid for reimbursement. Other codes (98000–98015) are invalid. For audio-only services, use standard E/M codes with modifier “93.”

2. Guidance for Unrecognized CPT Codes

Since the Centers for Medicare & Medicaid Services (CMS) does not recognize the new CPT Telemedicine Services codes, CMS directs physicians to refer to the list of telehealth services for Calendar Year 2025 and choose the most appropriate code for the service rendered.

3. Extension of Telehealth Flexibilities

The American Relief Act of 2025 extended waivers on geographic, site-of-service, and practitioner-type restrictions through March 31, 2025. This means Medicare patients in non-rural areas and those accessing telehealth from home can continue receiving services without additional barriers.

It is crucial for providers to review payer-specific policies and confirm billing practices with each insurer, as telehealth coverage and reimbursement can vary significantly between Medicare, Medicaid, and commercial payers. Contact Yeo & Yeo Medical Billing & Consulting for additional guidance on how these changes may impact your practice.

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued its final rule for the 2025 Medicare Physician Fee Schedule (PFS), with changes effective January 1, 2025.

Payment Rates

The conversion factor will decrease by 2.83% to $32.35 due to the expiration of a temporary increase and a 0% statutory update.

Telehealth Services

Unless Congress acts, pre-COVID geographic and provider restrictions for most telehealth services will resume in 2025. However, audio-only services will remain covered, and practitioners can use their enrolled address for telehealth provided from home.

Quality Payment Program

The Merit-Based Incentive Payment System (MIPS) performance threshold remains at 75 points, with six new MIPS pathways for specific specialties starting in 2025.

Additional Changes

• New coding and payment for caregiver training, primary care, cardiovascular risk assessment, post-op care, and behavioral health.
• Changes to the Medicare Shared Savings Program (MSSP), including a health equity benchmark adjustment and advance savings for successful Accountable Care Organizations (ACOs).
• The 1.88% APM Incentive Payment will end after 2024 unless extended by Congress, and CMS plans to increase the Qualifying APM Participant (QP) thresholds.

Additional information about the final rule may be found in the PFS fact sheet. Contact Yeo & Yeo Medical Billing & Consulting for additional guidance on how these changes may impact your practice.

Closing a medical practice can be complex and overwhelming. Every detail requires careful attention to avoid complications, from notifying patients to managing financial obligations. Yeo & Yeo understands these challenges and offers support to ensure a seamless transition.

Our Closing a Practice Checklist includes a list of preparations, notifications, and tasks that should be completed from 90 days out to the final day of closure.

Download the Checklist

Whether you’re starting, buying, selling, or closing a practice, our dedicated team has the experience and insight to guide you every step of the way.

Download the Checklist

Starting your own medical practice is a significant step in your professional journey, filled with excitement and challenges. As a healthcare professional, you’re likely facing several questions and concerns, such as:

• How do I navigate the complex legal and regulatory landscape?
• What financial and tax-smart considerations should I prioritize?
• How can I ensure my practice is operationally efficient from day one?
• What are the best practices for medical billing and revenue cycle management?

Establishing a medical practice involves a meticulous series of steps, and these are just a few of the critical issues you’ll need to address. At Yeo & Yeo, we understand these challenges. Our dedicated and credentialed healthcare team, comprised of practice management consultants, healthcare CPAs, billing specialists, personal financial planners, and more, has guided numerous practitioners through the process.

As you start a new medical practice, use this checklist to help you stay organized and focused. By following these steps, you’ll be well-equipped to set your practice on a path to thrive. For guidance navigating your journey, reach out to Yeo & Yeo.

Healthcare Common Procedure Coding System (HCPCS) code G2211 is an add-on code with the code set of 99211-99215. The intent behind the creation of the G2211 code is to improve patient care and outcomes by better managing serious and complex health issues through a longitudinal care plan. This plan is followed throughout all phases of the patient’s care to improve overall outcomes and quality of care.

Reporting G2211

The relationship between the provider and patient is paramount in deciding whether to report this HCPCS code. You should consider using this code if:

• You are the continuing focal point for all needed services.
• You provide ongoing care for a single, serious or complex condition.

If these criteria do not apply, you should not report G2211.

When reporting G2211, ensure your documentation clearly identifies the history, current treatment plan, goals of care, and any previous episodic similar events with adverse outcomes. You will also want to list any concerns or considerations of the current episode of care. Ensure you continuously update your longitudinal care plan with the patient’s events or episodes. Remember that according to the AMA definition, a problem must be evaluated and treated at the encounter by the provider who is reporting the service and not just pulled forward from a list of previous conditions.

When Not to Report G2211

You should avoid using this code if:

• Your relationship with the patient is of a discrete, routine, or time-limited nature, or comorbidities are not present or not addressed.
• You do not plan to take responsibility for subsequent, ongoing medical care for the patient with consistency and continuity over time.

Additionally, the code is not to be reported if you are billing for other services that would be considered a separately identifiable service and would require reporting a 25 modifier on the office or other outpatient visit, code set 99211-99215. Please note that these guidelines could change in 2025, pending the Medicare fee schedule and Quality Payment Program final rule.

In summary, this code should not be reported for every patient you treat. It is to account for the extra time, effort, and resources that go into building a long-term relationship with a patient and providing consistent care for their healthcare needs.

The CMS G2211 FAQ document and G2211 Reference Card help answer questions related to the use of the add-on code. Contact Yeo & Yeo Medical Billing & Consulting for additional billing and coding guidance.

Yeo & Yeo Medical Billing & Consulting (YYMBC) proudly celebrates 26 years of dedicated service and innovation in medical billing and practice management consulting. Since our inception in 1998, we have evolved into a trusted partner, supporting physicians, group practices, and healthcare organizations throughout Michigan in achieving operational excellence.

Roots in excellence and innovation

Our roots trace back more than a century when Yeo & Yeo CPAs began serving the healthcare industry in Saginaw, Michigan. What started as a small team has grown to a diverse group of over 30 consultants, medical billers and coders focused on helping physicians and medical practices thrive.

Under the leadership of YYMBC President Kati Krueger, the company has embraced technological advancements and implemented cutting-edge solutions, including robotic process automation (RPA), to streamline workflow. These innovations ensure efficient operations and enhance client experiences. Through web-based connectivity, our clients have transparency into every outstanding claim. This transparency brings peace of mind, knowing that everything is working as it should.

Krueger emphasizes, “Embracing the latest technologies is pivotal in our commitment to exceptional service. Applying these technologies, we enhance accuracy, streamline processes, and empower our team to help our clients succeed.”

Specialized knowledge and comprehensive solutions

YYMBC stands apart with its commitment to staying ahead of industry changes. Our team provides specialized knowledge in coding, compliance, chart audits, and practice management consulting. We combine our consultative services with offerings from Yeo & Yeo CPAs & Advisors, Yeo & Yeo Technology and Yeo & Yeo Wealth Management, presenting comprehensive solutions for healthcare professionals. Our goal is to ensure efficiency, compliance, and profitability in an ever-evolving landscape.

 “We have a great team of medical billers who work hard and strive to get the maximum reimbursement for our clients. We continually educate our staff so they know the ever-changing policies and rules,” says Krueger.

Denise Garrett, Billing Manager at YYMBC, emphasizes the sense of security and support our clients experience: “You have a team of people available who have specializations in multiple areas, especially now that billing is more complicated than ever.”

Investing in our community

Beyond our professional endeavors, YYMBC is proud to invest in our community through the Yeo & Yeo Foundation. We believe in giving back and supporting initiatives that make a positive impact. Some of the organizations we proudly support include Aaron’s Gifts from Home, Child Abuse and Neglect Council, Michigan Special Olympics – Area 9, Humane Society of Bay County, and many more. 

Our gratitude

Reflecting on this remarkable 26-year journey, we express our gratitude to all past and present clients and colleagues. Your trust and collaboration have been instrumental in our success. Krueger sums it up beautifully: “We want to create the best experience for our clients and our people.” With an enthusiastic, specialized team, YYMBC looks forward to the next chapter.

Here’s to 26 years of excellence and to many more ahead!

This article was updated on June 24, 2024.

Health insurance giant UnitedHealth Group confirmed a ransomware attack on its subsidiary, Change Healthcare (CHC). The cyberattack began on February 21 and continues to disrupt hospitals and pharmacies nationwide.

Change Healthcare continues to address the matter and is working to understand the impact on members, patients and customers. Change Healthcare has a high level of confidence that only Change Healthcare was affected by this issue and that Optum, UnitedHealthcare and UnitedHealth Group systems are unaffected.

In a recent statement, Change Healthcare said, “We are working on multiple approaches to restore the impacted environment and will not take any shortcuts or additional risk as we bring our systems back online. We will continue to be proactive and aggressive with all our systems and if we suspect any issue with the system, we will immediately take action and disconnect. We will provide updates as more information becomes available.”

On June 20, CHC began providing notice to customers whose members’ or patients’ data was involved in the incident. In late July, CHC plans to send direct notice (written letters) to affected individuals for whom CHC has a sufficient address.

To meet HIPAA requirements, CHC has provided a substitute notice link for customers to add to their website to provide information about the incident for their patients/members even if they have not been identified as impacted: https://www.changehealthcare.com/hipaa-substitute-notice.

The notice helps individuals understand what happened and gives them information on steps they can take to help protect their privacy, including enrolling in two years of complimentary credit monitoring and identity theft protection services.

More information, including frequently asked questions for CHC customers and individuals, is available here: changecybersupport.com. Call center support is also available Monday through Friday, 8:00 a.m. – 8:00 p.m. at 1-866-262-5342.

Yeo & Yeo will provide an update when more information becomes available from Change Healthcare.

Yeo & Yeo Medical Billing & Consulting is pleased to announce that Eva Rudich has earned the Certified Professional Compliance Officer (CPCO^®) Credential. The CPCO credential recognizes Rudich’s knowledge of healthcare compliance, including internal compliance reviews, audits, risk assessments, and staff education and training.

The CPCO designation is awarded to medical billing professionals who, through rigorous examination and experience, have a proven knowledge to effectively develop, implement, and monitor healthcare compliance programs. To earn the credential, Rudich passed a comprehensive exam covering topics including daily operational aspects of compliance programs, key laws and regulations, and policies used to address potential fraud and abuse, including associated penalties and fines.

“Earning the CPCO credential is a tremendous accomplishment,” said Kati Krueger, President of Yeo & Yeo Medical Billing & Consulting. “Eva’s increased knowledge of healthcare compliance will continue to benefit clients and YYMBC, ensuring accuracy in billing, reducing risks, and maintaining the highest ethical standards.”

Rudich is a medical biller and account manager with more than 32 years of medical billing and coding experience. She also holds the Certified Billing & Coding Specialist (CBCS) credential and the Certified Professional Coder (CPC^®) credential. Her areas of specialization include managing accounts for internal medicine, family practices, hospitalist groups, and gastroenterology. She is a member of the American Academy of Professional Coders and the National Healthcare Association.

Rudich said that continuing education is invaluable when it comes to serving clients. “Rules and laws change regularly, especially in healthcare. While I have become quite familiar with healthcare compliance through the years, earning this credential has given me even more knowledge that I can use to assist and educate providers and their staff.”

The Centers for Medicare & Medicaid Services (CMS) released the final 2024 Medicare Physician Fee Schedule (PFS) rule, which in addition to major payment implications, includes changes to the Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) participation options and requirements for 2024. The final rule:

• Sets the 2024 Medicare payment rates for physician services. For 2024, CMS finalized a conversion factor of $32.7442 and $20.4349 for Anesthesia (a decrease of -3.4% and -3.3%, respectively, from final 2023 rates);
• Implements E/M add-on code G2211 and defines the “substantive portion” of a split (or shared) E/M visit to mean more than half of the total time spent by the physician or nonphysician practitioner or a substantive part of the medical decision making;
• Reimburses telehealth services furnished to patients in their homes at the typically higher, non-facility PFS rate;
• Allows direct supervision by a supervising practitioner through real-time audio and video interaction telecommunications through 2024;
• Continues coverage and payment of telehealth services included on the Medicare Telehealth Services List through 2024;
• Pauses implementation and rescinds the Appropriate Use Criteria program regulations;
• Maintains the performance threshold of 75 points for all three MIPS reporting options;
• Adds five new MIPS Value Pathways related to women’s health, prevention and treatment of infectious disease, quality care in mental health/substance use disorder, quality care for ear, nose, and throat, and rehabilitative support for musculoskeletal care;
• Makes numerous changes to the Medicare Shared Savings Program (MSSP) such as revising the MSSP quality performance standard, modifying the program’s benchmarking methodology, and determining beneficiary assignment under the MSSP; and,
• Ends the 3.5% APM Incentive Payment after the 2023 performance year/2025 payment year, and transitions to a Qualifying APM Conversion Factor in the 2024 performance year/2026 payment year.

The calendar year 2024 PFS final rule is one of several final rules that reflect a broader Administration-wide strategy to create a more equitable health care system that results in better access to care, quality and affordability.

For more detailed information, refer to the PFS fact sheet and the 2024 Quality Payment Program Final Rule Resources within the QPP Resource Library.

Yeo & Yeo Medical Billing & Consulting (YYMBC) proudly marks a significant milestone, celebrating 25 years of dedicated service and innovation in medical billing and practice management. Established in 1998, the company has evolved into a trusted partner, supporting physicians, group practices, and healthcare organizations throughout Michigan in achieving operational excellence.

A legacy of growth

Yeo & Yeo Medical Billing & Consulting has roots dating back more than 100 years when Yeo & Yeo CPAs began serving the healthcare industry in Saginaw, Michigan. In 1998, Affiliated Medical Billing, as it was known then, started with a small team and quickly grew with a focus on streamlining physician practices and enhancing business functions.

In 2017, Kati Krueger became president of YYMBC. With her leadership, the company has embraced technological advancements, implementing cutting-edge solutions like robotic process automation, ensuring efficient operations and enhanced client experiences.

“Embracing the latest technologies is pivotal in our commitment to providing exceptional service,” said Krueger. “Applying these technologies, we enhance accuracy, streamline processes, and empower our team to help our clients thrive.”

Denise Garrett, billing manager at YYMBC, emphasized how technology has transformed their services, stating, “With today’s web-based connectivity, our clients can see every outstanding claim. It is more transparent now for the client and gives them peace of mind that everything is working as it should.”

A testament to excellence

YYMBC stands apart with its commitment to staying ahead of industry changes, providing specialized knowledge in coding, compliance, medical audits, and practice management. Their consultative services, combined with offerings from Yeo & Yeo CPAs & Advisors and Yeo & Yeo Technology, present comprehensive solutions for healthcare professionals, ensuring efficiency and compliance.

Krueger said, “We have a great team of medical billers who work hard and strive to get the maximum reimbursement for our clients. We continually educate our staff so they know the ever-changing policies and rules. We remain committed to growth and constantly evolving our service offerings to meet the changing needs of the healthcare landscape.”

Traci Cook, account manager at YYMBC, added, “There is a sense of security and support because you have a team of people available who have specializations in multiple areas, especially now that billing is more complicated than ever.”

A bright future ahead

As Yeo & Yeo Medical Billing & Consulting’s professionals celebrate this remarkable 25-year journey, they express their gratitude to all past and present clients and colleagues for their trust and collaboration.

“We want to create the best experience for our clients and our people,” Krueger said. “Our success wouldn’t be possible without their continued trust and hard work. We are proud to celebrate this milestone and excited for the opportunities the future holds.”

For more information about Yeo & Yeo Medical Billing & Consulting and its services, please visit www.yeoandyeomedicalbilling.com.

Yeo & Yeo Medical Billing & Consulting is pleased to announce that Denise Garrett has earned the Certified Professional Biller (CPB^®) Credential. The CPB credential recognizes Garrett’s knowledge in maintaining all aspects of the revenue cycle, particularly patient and payer billing and collections.

The CPB designation is awarded to medical billing professionals who, through rigorous examination and experience, have proven knowledge of submitting claims compliant with government regulations and private payer policies. CPBs are expected to follow up on claim statuses, resolve claim denials, submit appeals, post payments and adjustments, and manage collections. To earn the credential, Garrett passed a comprehensive exam covering topics including the application of payer policies, compliance rules, healthcare regulations, CPT^® procedure codes, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes.

“Denise is a distinguished member of our team,” said Yeo & Yeo Medical Billing & Consulting President Kati Krueger. “Earning the CPB credential is an accomplishment that underscores her unwavering dedication, extensive knowledge, and the multitude of credentials she has acquired over the years to help better serve our clients. Her passion for her work and her drive to improve her skills continue to set her apart as a leader in her field.”

Garrett is a billing manager with more than 20 years of medical billing and coding experience. She holds many credentials, including the Certified Professional Coder (CPC), Certified Physician Practice Manager (CPPM^®), Certified Professional Compliance Officer (CPCO™), Certified Professional Medical Auditor (CPMA^®), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), and Certified General Surgery Coder (CGSC). Her areas of specialization include coding diagnoses, services, and procedures for physician practices, as well as meeting the business needs of healthcare entities through finding operational efficiencies, staff training, and technology solutions. Garrett serves on the national board of directors of the American Academy of Professional Coders Chapter Association (AAPCCA). She is also a member of the National Alliance of Medical Auditing Specialists.

Garrett said that continuous learning and earning credentials like the CBP have helped her elevate the level of service she can provide to clients. “I continue to stay current with new developments in medical billing and gain knowledge in all areas of revenue cycle management, so I am armed with the tools necessary to help our healthcare clients succeed.”