New ‘Visual Combo’ Code Brings Reimbursement Risks

New ‘Visual Combo’ Code Brings Reimbursement Risks

Effective January 1, 2026, the Centers For Medicare and Medicaid Services mandated a critical coding change for urgent care: Visually read COVID-19/flu combination tests must now be billed under the single code CPT 87812. This replaces the previous standard of unbundling the tests into 2 separate codes (CPT 87811 and CPT 87804) and was intended to be revenue-neutral. However, a national analysis of January 2026 data by Urgent Care Consultants exclusively for JUCM reveals a …

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What’s New in Telemedicine for 2025?

What’s New in Telemedicine for 2025?

Phyllis Dobberstein, CPC, CPMA, CPCO, CEMC, CCC The American Medical Association (AMA) added a Telemedicine Services category to the Evaluation and Management (E/M) section of the Current Procedural Terminology (CPT) code set. Codes are divided up by the technology used and the patient type (ie, new vs. established). These codes are for synchronous, real-time interactive encounters between the provider and the patient. Codes are leveled by medical decision making (MDM) or time, which is similar …

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Developing Data: July/August, 2014

These data from the 2012 Urgent Care Industry Benchmarking Study are based on a sample of 1,732 urgent care centers; 95.2% of the respondents were UCA members. Among other criteria, the study was limited to centers that have a licensed provider onsite at all times; have two or more exam rooms; typically are open 7 days/week, 4 hours/day, at least 3,000 hours/year; and treat patients of all ages (unless specifically a pediatric urgent care). A …

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