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

Institutional outpatient therapy providers are experiencing claims being denied by their Medicare Administrative Contractor (MAC) beginning on and after April 1, 2023 for claims received by the MAC. In this article, I will answer the following questions: