Effective for dates of service on or after January 15, 2026, CMS is starting the WISeR (Wasteful and Inappropriate Service Reduction) model in 6 states where prior authorizations are required for 14 different surgical and/or procedural services, which will affect both anesthesia and chronic pain providers in those states.  If an approval is not obtained prior to performing the procedure, Medicare will not pay for the service until a prepayment review is performed.  If the pre

On November 12, 2025, President Trump signed a Continuing Resolution (“CR”) that ended the government shutdown, and among other things, extended the telehealth flexibilities through January 30, 2026.  This week CMS published updated Telehealth FAQs in which the following was confirmed: 1.     Patient Residence and Location .   Through January 30, 2026, Medicare beneficiaries do not have to live in rural areas or be present in a facility when receiving telehealth services.  In

On October 31, 2025, Medicare released the 2026 Final Rule for the Physician's Fee Schedule, which contains the new Medicare changes being implemented next year. Here are the highlights insofar as they affect anesthesia and chronic pain. Most of the changes relates to chronic pain. 1.     Conversion Factors (“CFs”).   Beginning in 2026, there are 2 CFs for anesthesia and non-anesthesia codes.  One CF is for providers participating in an “alternative payment model” (“APM”),

Just a reminder that the Medicare COVID telehealth flexibilities are set to expire at the end of this month if not extended by Congress...

Novitas (Medicare carrier for 2 jurisdictions and the administrator for First Coast Medicare in FL) sent me an email today stating that...

Last year the Biden administration attempted to circumvent the U.S. Supreme Court’s reversal of Roe v. Wade by adopting a Final Rule that...

Just a quick reminder that as of July 5, 2025, each of you as covered entities are supposed to be implementing notices of...