Medicare billing guides
Plain-language answers to billing questions, with live rates and the CMS source for every rule.
Visits and programsG2211: Medicare Billing Guidelines, RVUs and Modifier 25
G2211 is Medicare's add-on for the ongoing relationship behind an office or home E/M visit. Who can bill it, the modifier 25 rule, RVUs and 2026 changes.
Visits and programsAnnual Wellness Visit Billing Codes (G0438, G0439) for Medicare
The annual wellness visit billing codes are HCPCS G0438 (first AWV) and G0439 (every AWV after). Eligibility, what's not covered, modifier 25, ACP and G2211.
ClaimsPlace of Service Codes for Medical Billing (POS 11, 10, 02, 22)
Place of service codes are the two-digit setting codes on every professional claim. The common POS codes, POS 10 vs 02, 19 vs 22, and which pay the facility rate.
Payment basicsFacility vs Non-Facility Rates: How Medicare Pays by Setting
Facility vs non-facility: Medicare's two fee schedule rates per code. Only the practice expense RVU differs, and the place of service code decides which applies.
Payment basicsMedicare Conversion Factor 2026 (QP and Non-QP) and 2027
The Medicare conversion factor for 2026 is 33.4009 for most clinicians and 33.5675 for qualifying APM participants. How it works, its history and the 2027 proposal.
Behavioral healthBilling Codes for Therapy: Psychotherapy Time Ranges (2026)
The billing codes for therapy sessions, 90832, 90834 and 90837, with their Medicare time ranges, add-on codes, crisis and family codes, and live 2026 rates.
Therapy billingBilling Codes for Physical Therapy: Medicare Guide (2026)
billing codes and physical therapy billing for Medicare: evaluations 97161–97164, timed codes like 97110 and 97530, GP, CQ and KX modifiers, and live rates.
Visits and programsIncident-To Billing: Medicare Rules and Requirements (2026)
Incident to billing lets a physician bill an NPP's office visit at 100% instead of 85%. Medicare requirements, 2026 virtual supervision and denial traps.
ModifiersModifier 25 vs 59 (and 51 vs 59, 24 vs 25) for Medicare
Modifier 25 vs 59: 25 goes on an E/M visit, 59 on a procedure that's bundled by an NCCI edit. When to use each, plus 51 vs 59, 24 vs 25 and the X modifiers.
Payment basicsWhat Is an RVU? Relative Value Units Explained (2026)
What is an RVU? A relative value unit is Medicare's measure of the resources behind a service. Work vs total RVUs, GPCIs and how RVUs become payment.