Medicare & Payer Updates

Medicare & Payer Updates

Medicare & Payer Updates

Fee schedule rules, Medicare program changes and payer policy updates that affect orthopedic reimbursement, explained with effective dates and primary sources.

Fee schedule rules, Medicare program changes and payer policy updates that affect orthopedic reimbursement, explained with effective dates and primary sources.

Fee schedule rules, Medicare program changes and payer policy updates that affect orthopedic reimbursement, explained with effective dates and primary sources.

Coding & Modifiers

Denials & Appeals

Prior Authorization

Workers’ Comp & Ancillary Services

RCM Benchmarks & Strategy

Guides

Guides

Guides

Calculator and pen on a printed statement, representing Medicare physician payment math

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Medicare & Payer Updates

CY2027 Medicare Physician Fee Schedule: What It Means for Orthopedic Practices

Oct 14, 2026

Key terms

Key terms

Key terms

Advance Beneficiary Notice (ABN)

Advance Beneficiary Notice (ABN) is the standard Medicare form, CMS-R-131, that physicians, providers and suppliers give an Original Medicare patient before a service Medicare is expected to deny, usually as not reasonable and necessary. The patient chooses whether to proceed and accept financial responsibility if Medicare does not pay.

HCPCS G2211

HCPCS G2211 is a Medicare add-on code, separately paid since January 1, 2024, that recognizes the added complexity of an office/outpatient E/M visit, and since 2026 a home or residence visit, when the practitioner is the patient’s ongoing hub for care or manages one serious or complex condition over time.

See how Rette catches orthopedic denials before claims go out

See how Rette catches orthopedic denials before claims go out

See how Rette catches orthopedic denials before claims go out

Rette reads the operative note in the EHR you already use, suggests codes and checks claims against payer and NCCI rules before submission.