As of October 1, 2025, the American Medical Association (AMA) CPT® Editorial Panel has released its latest set of Proprietary Laboratory Analyses (PLA) code changes. The update includes 25 new PLA codes, two deletions, and one revision.
In November 2025, Aetna announced a major shift in its inpatient admission payment policy that could have significant financial consequences for hospitals. While the change appears to simplify approvals under the Two-Midnight Rule, it introduces hidden risks that may lead to reduced payments and eliminate hospitals’ rights to appeal.
The healthcare policy landscape in 2025 is transforming, affecting reimbursement models, telehealth expansion, and patient access rights. For providers, staying informed and proactive is not options - it's essential for financial stability and regulatory compliance.
The American Medical Association (AMA) introduced 17 new CPT® codes for telemedicine E/M services in 2025. These codes reflect the growing demand for both audio-video and audio-only care, ensuring providers can accurately document and report virtual encounters.
On August 21, 2025, the Centers for Medicare & Medicaid Services (CMS) released its fourth quarter update to the HCPCS Level II code set. This update impacts a wide range of healthcare providers who report services, supplies, drugs, and equipment.
From status indicator (SI) adjustments to new vaccine codes and skin substitute product classifications, the changes highlight CMS’s ongoing efforts to align payment policy with clinical and regulatory developments.