Each year, the Centers for Medicare and Medicaid Services (CMS) issues the dollar amount that must be met in order to appeal to the Administrative Law Judge (ALJ). For calendar year 2026, that dollar amount is

As many of you have found out the hard way, the Centers for Medicare and Medicaid Services (CMS) implemented a new program called Targeted Probe and Educate (TPE) where the goal of the program is to help providers and suppliers reduce claim denials and appeals through one-on-one education. CMS uses data analysis to identify providers and suppliers who have high claim error rates or unusual billing practices, and items and services that have high national error rates and are a financial risk to Medicare. Upon data analysis, if you are not an outlier in any of the above areas, you