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Showing posts with the label Global Maternity Bundle

What Is the CY2026 Efficiency Adjustment and How Does It Impact Internal Medicine Billing?

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The CY2026 Efficiency Adjustment is one of the important changes introduced under the 2026 Medicare Physician Fee Schedule. Effective January 1, 2026, CMS finalized a 2.5% reduction to the work RVUs of most non-time-based services . However, the adjustment does not apply broadly to every service billed by an internal medicine practice. Time-based services, including many evaluation and management (E/M) and care management services, are excluded. For internal medicine practices, understanding which services are affected is important because the adjustment can change reimbursement for certain procedures and ancillary services even when claims continue to process normally. For a detailed overview, practices can review What Is the CY2026 Efficiency Adjustment and How Does It Impact Internal Medicine Billing? . What Is the CY2026 Efficiency Adjustment? CMS finalized the efficiency adjustment as part of the CY2026 Physician Fee Schedule. The policy applies a -2.5% adjustment to the work comp...

How Can Providers Bill Outside the Global Maternity Bundle Without Triggering Denials?

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Providers can bill outside the global maternity bundle without triggering denials by correctly identifying non-global services, using accurate documentation, and applying proper coding and modifiers. OB/GYN billing is highly regulated, and incorrect handling of services outside the global package often results in denied or delayed claims. Understanding what qualifies as billable outside the bundle is essential for protecting revenue. What Is Included in the Global Maternity Bundle? The global maternity bundle typically includes routine antepartum care, delivery services, and postpartum care within a defined period. Services generally included are: Routine prenatal visits Vaginal or cesarean delivery Postpartum visits within the global period Billing any included service separately can lead to claim denials . Which Services Can Be Billed Outside the Global Maternity Bundle? Certain services are not included in the global maternity bundle and may be billed separate...