Monthly Archives: April 2025

2.6% payment increase for inpatient rehab facilities in 2026 sounds promising, but hidden compliance risks could erase gains. CMS’s update includes stricter audits, tweaked outlier thresholds, and changes in quality reporting requirements. Facilities must juggle case-mix weight shifts, wage index updates, and new submission rules. Pyramids Global helps providers turn these challenges into opportunities by offering gap alerts, penalty shields, case-mix optimization, and future-proofing strategies. Don’t let your boost slip away—partner with Pyramids Global to maximize revenue and stay ahead of every CMS change.

CMS finalizes a 5.06% Medicare Advantage rate hike for 2026, surpassing the earlier 2.23% proposal—fueling insurer gains but pressuring providers. While payers enjoy a $25B boost, physicians face pay cuts, tighter audits, and tougher risk adjustment models. Pyramids Global steps in with coding audits, denial defense, and equity-focused workflows to protect clinics from clawbacks and lost revenue. With new drug caps, shifting star ratings, and outcome-based reimbursements, providers can’t afford to fall behind. Pyramids Global ensures you’re not just compliant—but always three moves ahead.

CMS 2026 Final Rule brings major changes to Medicare billing—stricter prior authorization rules, complex dual-eligible modifiers, and new Part D pharmacy requirements. While the updates aim to streamline care, they also increase the risk of denials and documentation errors. From missing appeal codes to rejected scripts, providers face more compliance pressure than ever. That’s where Pyramids Global steps in. We simplify the complexities with smart audits, real-time updates, and claim-ready tools tailored to CMS 2026 standards—helping clinics stay compliant, reduce denials, and get paid faster in an ever-changing billing landscape.

Trump’s Health Equity office shutdown has ignited legal turmoil and widespread concern among providers. The closure of key minority health offices under CMS and HHS disrupts billing guidance, equity-focused coding, and care for underserved communities. With critical data pipelines severed and staff ousted, providers face rising denials and audit risks. What once offered clarity—like rural telehealth modifiers and social determinant “Z codes”—is now gone. As disparities grow invisible, Pyramids Global steps in, offering coding expertise, audit protection, and regulatory updates to help clinics navigate this chaos and safeguard vulnerable patient populations.

Trump’s Healthcare Tech push is moving fast—with big changes for providers. From AI initiative to extended telehealth rules and expanded home-based hospital care, these policies bring both opportunity and complexity. New billing codes, compliance rules, and hybrid care models are already creating challenges. That’s where Pyramids Global steps in. We simplify AI billing, flag telehealth errors before claims go out, and decode home care coding. As tech transforms healthcare, we help you stay ahead—so you can focus on patients, not paperwork. Let us handle the red tape.