Laboratory revenue cycle management encompasses every operational process connecting clinical laboratory services to collected Medicare reimbursement – and in August 2026, it has become the most actionable lever available to laboratory executives preparing for a confirmed payment shift. The Consolidated Appropriations Act, 2026, signed February 3, 2026, delayed all PAMA-related Clinical Laboratory Fee Schedule (CLFS) rate reductions through December 31, 2026 – the seventh Congressional intervention since PAMA was enacted [1]. But the reprieve is temporary.

Most of what gets called a coding problem is not a coding problem. It is a documentation problem that surfaces in the co...
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For most of the past decade, Medicare Advantage risk adjustment compliance was understood primarily through the lens of ...
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Ambulatory Surgery Centers (ASCs) are one of the fastest-growing segments of U.S. healthcare. Advances in minimally inva...
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CMS's proposed rule arrives against a backdrop of sustained program success and measurable improvements over time....
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CMS finalized the 2026 Medicare Physician Fee Schedule (MPFS) in October 2025, with policies effective January 1, 2026. ...
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Two things converged in 2026 that make HCC risk adjustment coding a more consequential financial function than it has ev...
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Why is physician coding creating more revenue risk in 2026? Physician coding is no longer just a compliance function sit...
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For years, many Medicare Advantage organizations treated HCC risk adjustment as a volume exercise: capture more diagnose...
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On June 1, 2026, the HHS Office of Inspector General published one of the most significant Medicare HCC risk adjustment ...
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