Local Coverage Determination: A Guide for Providers

Introduction Medical billing is a field that demands precision, knowledge of payer rules, and compliance with regulatory policies. Among the terms that healthcare providers and billing professionals encounter, local coverage determination plays a central role in how claims are processed by Medicare. For practices working with patients covered under federal…
Read More
90834 CPT Code

90834 CPT Code: A Complete Guide for Mental Health Billing 

Introduction  For behavioral health and psychotherapy, accurate medical billing is important for timely reimbursement. One of the most commonly used codes in psychotherapy is the 90834 CPT Code, which represents a standard 45-minute psychotherapy session. For providers, understanding CPT 90834, its description, time range, and reimbursement rules is very important,…
Read More
ABA Therapy Billing

ABA Therapy Billing: A Complete Guide for Providers

Introduction Applied Behavior Analysis (ABA) therapy is one of the most recommended treatments for individuals with autism spectrum disorder and related conditions. In this case the clinical progress is the main goal, financial sustainability plays an important role to keep healthcare practices running smoothly. For healthcare providers, the most challenging…
Read More
Downcoding in Medical Billing

Downcoding in Medical Billing: Complete Guide for Providers

Introduction In the healthcare revenue cycle, downcoding in medical billing is one of the most important topics. This can directly impact the payment reimbursements, compliance, accuracy, and relationship between insurance and healthcare providers. While many healthcare professionals understand the risks of upcoding and downcoding, they mostly don’t know exactly about…
Read More