An outpatient care model designed to serve high-cost Medicaid patients was found to significantly reduce healthcare spending, hospital admissions, and emergency department visits, according to a study published in The American Journal of Managed Care.
The COVID-19 pandemic kickstarted a shift in surgical care from the inpatient to outpatient setting due to elective surgeries in hospitals being suspended. The popularity of outpatient surgeries after the pandemic continued to grow, according to a study published in Medical Care Research and Review.
The AMA announced several changes coming to maternity care service codes for the 2027 CPT code set in a move aimed to allow care to be reported more specifically across all phases of pregnancy. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Several updates to the Ambulatory Surgical Center payment system recently went into effect, so ensure that your staff knows about these changes, including new HCPCS codes, a deleted code, and revisions.
Early dose adjustments for individuals undergoing methadone treatment in outpatient settings were associated with improved treatment retention, according to a study published in PLOS Medicine.
A greater telemedicine uptake among mental health specialists did not result in improved access to care for patients in communities with specialist shortages, according to a study published in JAMA Open Network.
Net spending on Medicaid outpatient prescription drugs grew substantially in recent years while the number of prescriptions paid by Medicaid only grew slightly, according to a recent issue brief from KFF.
Changes to the Medicare provider-based billing requirements for off-campus outpatient departments are coming with the passage of the Consolidated Appropriations Act last month.
The February 4 issue of CMS’ MLN Matters outlines the January 2026 update to the hospital OPPS, including COVID-19 CPT code changes; new HCPCS codes for drugs, biologicals, and radiopharmaceuticals; and new unlisted skin substitute product HCPCS codes. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Emergency department visits resulting in outpatient treatment increased sharply, while visits leading to inpatient admission did not—particularly among Medicaid patients—according to research recently published in JAMA Health Forum.
A number of Medicare telehealth flexibilities extensions in place until January 30, 2026, lapsed during the partial U.S. government shutdown that began January 31, 2026.
A study recently published in JAMA Network Open examined trends in outpatient mental health care among Medicare fee-for-service beneficiaries before, during, and after the COVID-19 pandemic.
CMS announced its A/B Medicare administrative contractors have withdrawn the local coverage determinations for skin substitute grafts/cellular and tissue-based products for the treatment of diabetic foot ulcers and venous leg ulcers.
CMS recently published a fact sheet outlining an update coming from all seven Medicare administrative contractors to the local coverage determinations for skin substitute grafts/cellular and tissue-based products for the treatment of diabetic foot ulcers and venous leg ulcers, which will be effective January 1, 2026. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
Clinics, specialty groups, and ambulatory care centers are facing systemic strains from the outpatient healthcare infrastructure, according to the Outpatient Pressure Index 2025 published by CERTIFY Health.
A recent cross-sectional analysis published in JAMA Psychiatry examined the breakdown of what percentage of mental health outpatients received their care in-person, via telehealth, or a hybrid. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS released its 2026 Outpatient Prospective Payment System final rule on November 21. The document finalizes many proposed policies, including increasing the payment rate, expanding the agency’s method to control unnecessary increases in the volume of outpatient services, revising the Ambulatory Surgical Center Covered Procedures List criteria, and setting the payment rate for the intensive outpatient program.
MDaudit, a revenue integrity software platform, recently released its annual report that examines trends in coding denials, audits, and technology based on data from the first three quarters of 2025. Note : To access this free article, make sure you first register here if you do not have a paid subscription.
CMS finalized changes to the Medicare Diabetes Prevention Program in the 2026 Medicare Physician Fee Schedule final rule, including updating weight collection requirements, extending flexibilities allowed during the COVID-19 public health emergency, and updating the online delivery modality of the program.
