Which Hospitalist Billing Companies Actually Protect E/M Revenue in 2026?

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Hospitalist practices face growing reimbursement challenges in 2026. Evaluation and Management (E/M) services remain one of the largest revenue sources for hospital-based providers, yet increasing payer scrutiny, documentation requirements, and coding complexities continue to put reimbursement at risk. Even minor documentation gaps can result in downcoding, denials, underpayments, or audit exposure. As a result, many hospitalist groups are reevaluating their revenue cycle strategies and asking an important question: Which hospitalist billing companies actually protect E/M revenue in 2026? The answer depends on a billing company's ability to strengthen documentation accuracy, reduce denials, optimize coding, and maintain strong Revenue Integrity throughout the revenue cycle. Why E/M Revenue Is Under Pressure in 2026 Hospitalist reimbursement is heavily dependent on E/M coding accuracy. Payers are increasingly reviewing claims for medical necessity, documentation support, physician ...
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Basics of Medicare Consolidated Billing for SNFs

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Need for Consolidated Billing for SNFs

Prior to the Balanced Budget Act of 1997 (BBA), a Skilled Nursing Facility (SNF) could elect to furnish services to a resident in a covered Part A stay, either, directly using its own resources; through the SNF's transfer agreement hospital; or under arrangements with an independent therapist (for physical, occupational, and speech therapy services). In each of these circumstances, the SNF billed Medicare Part A for the services.

However, the SNF also had the further option of ‘unbundling’ a service altogether; that is, the SNF could permit an outside supplier to furnish the service directly to the resident, and the outside supplier would submit a bill to Medicare Part B, without any involvement of the SNF itself.

This practice created several problems, including the following:

  • Potential for duplicate (Parts A/B) billing if both the SNF and outside supplier billed;
  • An increased out-of-pocket liability incurred by the beneficiary for the Part B deductible and coinsurance even if only the supplier billed; and
  • A dispersal of responsibility for resident care among various outside suppliers adversely affected quality (coordination of care) and program integrity

Then Balanced Budget Act of 1997 (BBA), was enacted, containing a Consolidated Billing (CB) requirement for SNFs. Under the CB requirement, an SNF itself must submit all Medicare claims for the services that its residents receive. Conceptually, SNF CB resembles the bundling requirement for inpatient hospital services that's been in effect since the early 1980s, assigning to the facility itself the Medicare billing responsibility for virtually the entire package of services that a facility resident receives, except for certain services that are specifically excluded.

To get more information about Medicare Consolidated Billing for SNFs click here: https://bit.ly/3vmPAjQ. Get in touch with us at: info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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