The AI Advantage: Navigating the 2026 Medicare Advantage Rate Bump

Published: Thu, 06/19/25

Updated: Thu, 06/19/25

Link to all things medical coding & billing

The AI Advantage: Navigating the 2026 Medicare Advantage Rate Bump

The Centers for Medicare & Medicaid Services (CMS) recently released its 2026 Medicare Advantage (MA) Rate Announcement (Opens in a new window), projecting a 5.06% average increase in payments to MA plans — a significant jump from 2025. This signals growing confidence in the Medicare Advantage model. But with this comes greater...

Emerging Medical Coding Regulations and Their Impact on Billing Accuracy

As we progress through 2025, the landscape of medical coding is shaped by a wave of new regulations from both governmental and commercial payers. These changes are designed to increase transparency, reduce fraud, and ensure that healthcare providers are reimbursed accurately for the care they deliver. However, the introduction of...

How AI is Enhancing Medical Coding Accuracy and Efficiency This Year

Artificial intelligence is fundamentally reshaping medical coding in 2025, offering new levels of accuracy and operational efficiency that were previously unattainable. As regulatory demands intensify and payer audits become more sophisticated, coding professionals are increasingly relying on advanced AI-driven platforms to...

What Coders Need to Know: Anticoagulant versus Antiplatelet – Coding Considerations

Continuing our look at areas where we see confusion we will examine the assignment of the long term use codes for anticoagulants versus antithrombotics/antiplatelets. GoodRx.com, in an article titled, “Antiplatelet vs. Anticoagulant Blood Thinners – 4 Things to Know,” details the basics coders need to keep in mind when assigning these codes. First...

ICD-11 in 2025: Evolution, Global Progress, and What to Watch

In the ever-evolving world of health information, few transitions generate as much anticipation and uncertainty as the adoption of a new international classification system. The 11th Revision of the International Classification of Diseases (ICD-11), developed by the World Health Organization (WHO), has reached a pivotal moment in 2025. It is no...

Ushering in a New Era of Digital and AI-Driven Healthcare

As healthcare continues to evolve in response to technological innovation and changing patient expectations, coding professionals are at the forefront of documenting that transformation. The CPT® 2025 code set, released by the American Medical Association, reflects a clear shift toward the integration of artificial intelligence (AI), digital...

P.O. Box 3824
Youngstown OH 44513
USA

Unsubscribe | Change Subscriber Options