Modifier 25 vs Modifier 59: When to Use Each
Modifier 25 vs Modifier 59: When to Use Each If your coders can’t explain the modifier 25 vs modifier 59 decision in one sentence, your claims are probably paying the price for it. These two modifiers get confused constantly, and that confusion drives real revenue loss: bundled E/M visits, denied procedure lines, and payer audits […]
Outsource Medical Billing Ohio | TMS Billings
Denied claims, slow reimbursements, and billing staff turnover are quietly draining Ohio practices every month. If you have been asking whether to outsource medical billing Ohio, you are asking the right question at exactly the right time. This guide — written by the TMS Billings revenue cycle management team — gives you an honest breakdown […]
AI Claim Scrubbing vs Human Review: 2026 Guide
AI Claim Scrubbing vs. Human Review: What Practice Owners Actually Need in 2026 If a vendor or your billing company has pitched you on “AI-powered” claim review in the last year, you’re not alone. AI claim scrubbing is now standard language in nearly every revenue cycle sales deck, and for good reason — denial rates […]
Medical Billing Pricing Models: % vs Flat Fee vs Per-Claim
If you’re comparing vendor quotes right now, you’ve likely received three very different numbers for essentially the same job. That happens because there’s no universal pricing standard in this industry—and understanding medical billing pricing models is the first step toward knowing whether your practice is overpaying. Our Medical Billing Services team works with practices of […]
Patient Collections in Healthcare Guide
Patient collections in healthcare is no longer a back-office afterthought — it is one of the most critical levers in your practice’s financial performance. As insurers shift more cost burden onto patients through higher deductibles and coinsurance, your patients have become your biggest payer. If your Revenue Cycle Management Services are not built to handle […]
2026 Medicare Physician Fee Schedule Impact
The 2026 Medicare physician fee schedule is final — and the headline “pay increase” hides a much more complicated story for your practice. CMS published the CY2026 Physician Fee Schedule in November 2025, introducing dual conversion factors, a new efficiency adjustment to work RVUs, tightened site-of-service payment rules, and expanded MIPS Value Pathways requirements. If […]
TMS CPT Codes 2026: 90867, 90868, 90869 Guide
If your practice offers transcranial magnetic stimulation, you already know that getting paid for it is its own specialty. Denial rates are high, payer rules are inconsistent, and one miscoded session can unravel an entire 36-session treatment course. Understanding TMS CPT codes 2026 is not optional — it is the foundation of a financially healthy […]
Switch Billing Providers Safely
Switching Medical Billing Providers Without Losing Claims: The 2026 Transition Checklist Switching medical billing providers is one of the most consequential decisions your behavioral health practice will make. Get it right, and you unlock better collections, cleaner claims, and less administrative burden. Get it wrong, and your revenue cycle can spiral into denial chaos, aged […]
Vaccine Billing Codes: CPT, NDC, and Denials
2026 Vaccine Billing Codes: The Full Guide to CPT, NDC, and Denial-Free Claims Immunization billing is one of the highest-volume — and most denial-prone — workflows in any pediatric practice. If your team is submitting vaccine claims without a precise, up-to-date understanding of vaccine billing codes, you are almost certainly losing reimbursement on services you […]
2026 Mental Health CPT Codes: The Full Guide
2026 Mental Health CPT Codes: The Full Guide to Billing Without Denials Mental health billing is one of the highest-risk revenue areas in outpatient practice today. Payers are tightening prior authorization requirements, CMS continues updating the fee schedule, and documentation standards keep rising. If your billing team is still running 2023 or 2024 workflows, your […]