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doi: 10.1016/j.arr.2015.10.005
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Here's what this guide covered in practical terms: the correct unit calculation using the 8-minute rule, the 2025 Medicare rate of $28.79 per unit and why it's been declining, every modifier required by provider type and payer, the documentation standard that CGS Medicare audits against, how to bill 97110 alongside 97530, 97112, and 97140 without triggering bundling denials, which ICD-10 codes pair correctly with the claim, how to appeal a denial using CARC codes and regulatory citations, and what the 2026 KX threshold change and the 2028 telehealth sunset mean for your practice planning
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