data/cms_rules_2025.csv

Rule_ID,Type,Target,Change,Impact_Score,Description
R2025_BUND_01,OPPS_Bundling,Orthopedics,APC Bundling,0.85,CMS 2025 OPPS Update: Orthopedic supply costs (HCPCS C1713) are now 'packaged' into APC 5114 flat fee. Separate pass-through billing is no longer permitted.
R2025_SEPSIS_02,DRG_Logic,Internal Medicine,Reclassification,0.78,"2025 Sepsis Reclassification: Sepsis with Major Complications (MCC) now requires documented 'Organ System Failure' for DRG 871. Failure to document results in downcode to DRG 872, risking $4,200 loss per case."
R2025_TKA_03,Site_of_Care,Orthopedics,Site-of-care shift,0.92,2025 TKA Shift: Total Knee Arthroplasty (TKA) procedures are being shifted from Inpatient (IPPS) to Outpatient (OPPS) for healthy populations. Projected reimbursement drop from $14k to $9k per case.
R2025_CODE_05,Coding_Addition,Cardiology,New CPT Codes,0.45,CMS 2025 update adds new descriptor codes for remote cardiac monitoring. $250 increase in reimbursement per patient per month for eligible heart failure cases.
R2025_NCD_06,NCD_LCD_Update,Neurology,Coverage Determination,0.72,New National Coverage Determination (NCD) for Alzheimer's therapeutics. Stringent clinical criteria for coverage must be met for Medicare payment eligibility.
R2025_VBP_07,Value_Based_Program,General Surgery,Penalty Increase,0.55,MSSP Shared Savings Update: Increased weighting for surgical site infection metrics. Organizations in the bottom 25th percentile face up to 2% billing reduction.
R2025_100,CC_MCC_Update,Endocrinology,Penalty Increase,0.41,2025 CC_MCC_Update update for Endocrinology. Focus on Penalty Increase with a systemic impact of 41.0%.
R2025_101,HCC_Revisions,Internal Medicine,APC Bundling,0.18,2025 HCC_Revisions update for Internal Medicine. Focus on APC Bundling with a systemic impact of 18.0%.
R2025_102,OPPS_Bundling,Gastroenterology,Penalty Increase,0.27,2025 OPPS_Bundling update for Gastroenterology. Focus on Penalty Increase with a systemic impact of 27.0%.
R2025_103,Telehealth,Endocrinology,Rate Standardization,0.51,2025 Telehealth update for Endocrinology. Focus on Rate Standardization with a systemic impact of 51.0%.
R2025_104,OPPS_Bundling,Urology,Site-of-care shift,0.25,2025 OPPS_Bundling update for Urology. Focus on Site-of-care shift with a systemic impact of 25.0%.
R2025_105,Telehealth,Endocrinology,Rate Standardization,0.18,2025 Telehealth update for Endocrinology. Focus on Rate Standardization with a systemic impact of 18.0%.
R2025_106,DRG_Logic,Gastroenterology,Inclusion Shift,0.75,2025 DRG_Logic update for Gastroenterology. Focus on Inclusion Shift with a systemic impact of 75.0%.
R2025_107,Value_Based_Program,Gastroenterology,APC Bundling,0.89,2025 Value_Based_Program update for Gastroenterology. Focus on APC Bundling with a systemic impact of 89.0%.
R2025_108,NCD_LCD_Update,Urology,Weight Shift,0.93,2025 NCD_LCD_Update update for Urology. Focus on Weight Shift with a systemic impact of 93.0%.
R2025_109,Payment_Policy,Neurology,APC Bundling,0.64,2025 Payment_Policy update for Neurology. Focus on APC Bundling with a systemic impact of 64.0%.
R2025_110,HCC_Revisions,Oncology,Coverage Determination,0.44,2025 HCC_Revisions update for Oncology. Focus on Coverage Determination with a systemic impact of 44.0%.
R2025_111,NCD_LCD_Update,Nephrology,Weight Increase,0.26,2025 NCD_LCD_Update update for Nephrology. Focus on Weight Increase with a systemic impact of 26.0%.
R2025_112,Site_of_Care,Neurology,Readmission Adjustment,0.11,2025 Site_of_Care update for Neurology. Focus on Readmission Adjustment with a systemic impact of 11.0%.
R2025_113,OPPS_Bundling,General Surgery,Coverage Determination,0.87,2025 OPPS_Bundling update for General Surgery. Focus on Coverage Determination with a systemic impact of 87.0%.
R2025_114,OPPS_Bundling,General Surgery,Reclassification,0.64,2025 OPPS_Bundling update for General Surgery. Focus on Reclassification with a systemic impact of 64.0%.
R2025_115,NCD_LCD_Update,Internal Medicine,Weight Shift,0.13,2025 NCD_LCD_Update update for Internal Medicine. Focus on Weight Shift with a systemic impact of 13.0%.
R2025_116,Site_of_Care,Neurology,Weight Decrease,0.25,2025 Site_of_Care update for Neurology. Focus on Weight Decrease with a systemic impact of 25.0%.
R2025_117,Site_of_Care,General Surgery,Weight Shift,0.94,2025 Site_of_Care update for General Surgery. Focus on Weight Shift with a systemic impact of 94.0%.
R2025_118,Coding_Addition,Internal Medicine,Penalty Increase,0.55,2025 Coding_Addition update for Internal Medicine. Focus on Penalty Increase with a systemic impact of 55.00000000000001%.
R2025_119,Value_Based_Program,Gastroenterology,New CPT Codes,0.29,2025 Value_Based_Program update for Gastroenterology. Focus on New CPT Codes with a systemic impact of 28.999999999999996%.
R2025_120,DRG_Logic,Internal Medicine,APC Bundling,0.41,2025 DRG_Logic update for Internal Medicine. Focus on APC Bundling with a systemic impact of 41.0%.
R2025_121,CC_MCC_Update,General Surgery,Weight Increase,0.91,2025 CC_MCC_Update update for General Surgery. Focus on Weight Increase with a systemic impact of 91.0%.
R2025_122,Site_of_Care,Internal Medicine,Weight Increase,0.91,2025 Site_of_Care update for Internal Medicine. Focus on Weight Increase with a systemic impact of 91.0%.
R2025_123,Site_of_Care,Internal Medicine,Rate Standardization,0.15,2025 Site_of_Care update for Internal Medicine. Focus on Rate Standardization with a systemic impact of 15.0%.
R2025_124,DRG_Logic,Oncology,Coverage Determination,0.52,2025 DRG_Logic update for Oncology. Focus on Coverage Determination with a systemic impact of 52.0%.
R2025_125,DRG_Logic,Neurology,Weight Decrease,0.85,2025 DRG_Logic update for Neurology. Focus on Weight Decrease with a systemic impact of 85.0%.
R2025_126,Coding_Addition,Pulmonology,Penalty Increase,0.7,2025 Coding_Addition update for Pulmonology. Focus on Penalty Increase with a systemic impact of 70.0%.
R2025_127,CC_MCC_Update,Orthopedics,APC Bundling,0.33,2025 CC_MCC_Update update for Orthopedics. Focus on APC Bundling with a systemic impact of 33.0%.
R2025_128,Quality_Penalty,Pulmonology,APC Bundling,0.86,2025 Quality_Penalty update for Pulmonology. Focus on APC Bundling with a systemic impact of 86.0%.
R2025_129,CC_MCC_Update,Urology,Weight Increase,0.21,2025 CC_MCC_Update update for Urology. Focus on Weight Increase with a systemic impact of 21.0%.
R2025_130,OPPS_Bundling,Nephrology,Site-of-care shift,0.13,2025 OPPS_Bundling update for Nephrology. Focus on Site-of-care shift with a systemic impact of 13.0%.
R2025_131,Coding_Addition,Neurology,Rate Standardization,0.85,2025 Coding_Addition update for Neurology. Focus on Rate Standardization with a systemic impact of 85.0%.
R2025_132,OPPS_Bundling,Internal Medicine,Inclusion Shift,0.51,2025 OPPS_Bundling update for Internal Medicine. Focus on Inclusion Shift with a systemic impact of 51.0%.
R2025_133,Telehealth,Pulmonology,Coverage Determination,0.26,2025 Telehealth update for Pulmonology. Focus on Coverage Determination with a systemic impact of 26.0%.
R2025_134,Coding_Addition,Urology,Site-of-care shift,0.15,2025 Coding_Addition update for Urology. Focus on Site-of-care shift with a systemic impact of 15.0%.
R2025_135,Coding_Addition,Cardiology,Site-of-care shift,0.47,2025 Coding_Addition update for Cardiology. Focus on Site-of-care shift with a systemic impact of 47.0%.
R2025_136,Coding_Addition,Endocrinology,Weight Shift,0.73,2025 Coding_Addition update for Endocrinology. Focus on Weight Shift with a systemic impact of 73.0%.
R2025_137,Quality_Penalty,Neurology,Rate Standardization,0.21,2025 Quality_Penalty update for Neurology. Focus on Rate Standardization with a systemic impact of 21.0%.
R2025_138,Payment_Policy,Neurology,Weight Increase,0.88,2025 Payment_Policy update for Neurology. Focus on Weight Increase with a systemic impact of 88.0%.
R2025_139,OPPS_Bundling,General Surgery,APC Bundling,0.33,2025 OPPS_Bundling update for General Surgery. Focus on APC Bundling with a systemic impact of 33.0%.
R2025_140,DRG_Logic,Gastroenterology,APC Bundling,0.38,2025 DRG_Logic update for Gastroenterology. Focus on APC Bundling with a systemic impact of 38.0%.
R2025_141,OPPS_Bundling,General Surgery,Readmission Adjustment,0.1,2025 OPPS_Bundling update for General Surgery. Focus on Readmission Adjustment with a systemic impact of 10.0%.
R2025_142,CC_MCC_Update,Internal Medicine,New CPT Codes,0.6,2025 CC_MCC_Update update for Internal Medicine. Focus on New CPT Codes with a systemic impact of 60.0%.
R2025_143,Coding_Addition,Oncology,Weight Decrease,0.31,2025 Coding_Addition update for Oncology. Focus on Weight Decrease with a systemic impact of 31.0%.
R2025_144,Telehealth,General Surgery,Readmission Adjustment,0.21,2025 Telehealth update for General Surgery. Focus on Readmission Adjustment with a systemic impact of 21.0%.
R2025_145,Payment_Policy,Neurology,New CPT Codes,0.22,2025 Payment_Policy update for Neurology. Focus on New CPT Codes with a systemic impact of 22.0%.
R2025_146,Site_of_Care,Neurology,New CPT Codes,0.12,2025 Site_of_Care update for Neurology. Focus on New CPT Codes with a systemic impact of 12.0%.
R2025_147,HCC_Revisions,Urology,Site-of-care shift,0.82,2025 HCC_Revisions update for Urology. Focus on Site-of-care shift with a systemic impact of 82.0%.
R2025_148,HCC_Revisions,Urology,APC Bundling,0.93,2025 HCC_Revisions update for Urology. Focus on APC Bundling with a systemic impact of 93.0%.
R2025_149,Quality_Penalty,Oncology,Weight Shift,0.66,2025 Quality_Penalty update for Oncology. Focus on Weight Shift with a systemic impact of 66.0%.
R2025_150,Coding_Addition,Nephrology,Weight Shift,0.65,2025 Coding_Addition update for Nephrology. Focus on Weight Shift with a systemic impact of 65.0%.
R2025_151,Telehealth,Cardiology,Reclassification,0.78,2025 Telehealth update for Cardiology. Focus on Reclassification with a systemic impact of 78.0%.
R2025_152,NCD_LCD_Update,General Surgery,Readmission Adjustment,0.31,2025 NCD_LCD_Update update for General Surgery. Focus on Readmission Adjustment with a systemic impact of 31.0%.
R2025_153,Quality_Penalty,Oncology,Rate Standardization,0.68,2025 Quality_Penalty update for Oncology. Focus on Rate Standardization with a systemic impact of 68.0%.
R2025_154,NCD_LCD_Update,Orthopedics,Inclusion Shift,0.52,2025 NCD_LCD_Update update for Orthopedics. Focus on Inclusion Shift with a systemic impact of 52.0%.
R2025_155,Value_Based_Program,Neurology,Weight Shift,0.38,2025 Value_Based_Program update for Neurology. Focus on Weight Shift with a systemic impact of 38.0%.
R2025_156,Telehealth,Neurology,APC Bundling,0.43,2025 Telehealth update for Neurology. Focus on APC Bundling with a systemic impact of 43.0%.
R2025_157,Site_of_Care,Nephrology,Coverage Determination,0.37,2025 Site_of_Care update for Nephrology. Focus on Coverage Determination with a systemic impact of 37.0%.
R2025_158,Site_of_Care,Cardiology,Weight Decrease,0.86,2025 Site_of_Care update for Cardiology. Focus on Weight Decrease with a systemic impact of 86.0%.
R2025_159,HCC_Revisions,General Surgery,Readmission Adjustment,0.93,2025 HCC_Revisions update for General Surgery. Focus on Readmission Adjustment with a systemic impact of 93.0%.
R2025_160,Payment_Policy,Cardiology,Weight Shift,0.67,2025 Payment_Policy update for Cardiology. Focus on Weight Shift with a systemic impact of 67.0%.
R2025_161,Value_Based_Program,General Surgery,Inclusion Shift,0.8,2025 Value_Based_Program update for General Surgery. Focus on Inclusion Shift with a systemic impact of 80.0%.
R2025_162,Telehealth,Cardiology,New CPT Codes,0.4,2025 Telehealth update for Cardiology. Focus on New CPT Codes with a systemic impact of 40.0%.
R2025_163,Coding_Addition,Nephrology,Penalty Increase,0.66,2025 Coding_Addition update for Nephrology. Focus on Penalty Increase with a systemic impact of 66.0%.
R2025_164,Telehealth,Neurology,New CPT Codes,0.18,2025 Telehealth update for Neurology. Focus on New CPT Codes with a systemic impact of 18.0%.
R2025_165,HCC_Revisions,Endocrinology,Site-of-care shift,0.49,2025 HCC_Revisions update for Endocrinology. Focus on Site-of-care shift with a systemic impact of 49.0%.
R2025_166,Payment_Policy,Orthopedics,Weight Shift,0.23,2025 Payment_Policy update for Orthopedics. Focus on Weight Shift with a systemic impact of 23.0%.
R2025_167,HCC_Revisions,Gastroenterology,Reclassification,0.42,2025 HCC_Revisions update for Gastroenterology. Focus on Reclassification with a systemic impact of 42.0%.
R2025_168,Site_of_Care,Neurology,Readmission Adjustment,0.23,2025 Site_of_Care update for Neurology. Focus on Readmission Adjustment with a systemic impact of 23.0%.
R2025_169,OPPS_Bundling,Endocrinology,Coverage Determination,0.33,2025 OPPS_Bundling update for Endocrinology. Focus on Coverage Determination with a systemic impact of 33.0%.
R2025_170,NCD_LCD_Update,Oncology,Weight Decrease,0.32,2025 NCD_LCD_Update update for Oncology. Focus on Weight Decrease with a systemic impact of 32.0%.
R2025_171,NCD_LCD_Update,Oncology,Weight Decrease,0.58,2025 NCD_LCD_Update update for Oncology. Focus on Weight Decrease with a systemic impact of 57.99999999999999%.
R2025_172,Quality_Penalty,Internal Medicine,Weight Increase,0.14,2025 Quality_Penalty update for Internal Medicine. Focus on Weight Increase with a systemic impact of 14.000000000000002%.
R2025_173,Payment_Policy,Cardiology,Weight Increase,0.78,2025 Payment_Policy update for Cardiology. Focus on Weight Increase with a systemic impact of 78.0%.
R2025_174,OPPS_Bundling,Pulmonology,Weight Increase,0.66,2025 OPPS_Bundling update for Pulmonology. Focus on Weight Increase with a systemic impact of 66.0%.
R2025_175,NCD_LCD_Update,Pulmonology,Coverage Determination,0.8,2025 NCD_LCD_Update update for Pulmonology. Focus on Coverage Determination with a systemic impact of 80.0%.
R2025_176,Value_Based_Program,Orthopedics,Weight Shift,0.53,2025 Value_Based_Program update for Orthopedics. Focus on Weight Shift with a systemic impact of 53.0%.
R2025_177,Value_Based_Program,Cardiology,Rate Standardization,0.88,2025 Value_Based_Program update for Cardiology. Focus on Rate Standardization with a systemic impact of 88.0%.
R2025_178,NCD_LCD_Update,Internal Medicine,APC Bundling,0.25,2025 NCD_LCD_Update update for Internal Medicine. Focus on APC Bundling with a systemic impact of 25.0%.
R2025_179,Site_of_Care,Pulmonology,Weight Decrease,0.28,2025 Site_of_Care update for Pulmonology. Focus on Weight Decrease with a systemic impact of 28.000000000000004%.
R2025_180,CC_MCC_Update,Internal Medicine,Penalty Increase,0.23,2025 CC_MCC_Update update for Internal Medicine. Focus on Penalty Increase with a systemic impact of 23.0%.
R2025_181,Payment_Policy,Endocrinology,Weight Increase,0.53,2025 Payment_Policy update for Endocrinology. Focus on Weight Increase with a systemic impact of 53.0%.
R2025_182,HCC_Revisions,Pulmonology,Readmission Adjustment,0.93,2025 HCC_Revisions update for Pulmonology. Focus on Readmission Adjustment with a systemic impact of 93.0%.
R2025_183,Quality_Penalty,Pulmonology,Site-of-care shift,0.22,2025 Quality_Penalty update for Pulmonology. Focus on Site-of-care shift with a systemic impact of 22.0%.
R2025_184,Payment_Policy,Internal Medicine,Inclusion Shift,0.5,2025 Payment_Policy update for Internal Medicine. Focus on Inclusion Shift with a systemic impact of 50.0%.
R2025_185,Site_of_Care,Endocrinology,New CPT Codes,0.17,2025 Site_of_Care update for Endocrinology. Focus on New CPT Codes with a systemic impact of 17.0%.
R2025_186,Site_of_Care,Endocrinology,Inclusion Shift,0.74,2025 Site_of_Care update for Endocrinology. Focus on Inclusion Shift with a systemic impact of 74.0%.
R2025_187,DRG_Logic,Cardiology,Rate Standardization,0.94,2025 DRG_Logic update for Cardiology. Focus on Rate Standardization with a systemic impact of 94.0%.
R2025_188,CC_MCC_Update,Nephrology,Reclassification,0.72,2025 CC_MCC_Update update for Nephrology. Focus on Reclassification with a systemic impact of 72.0%.
R2025_189,CC_MCC_Update,Oncology,Weight Decrease,0.34,2025 CC_MCC_Update update for Oncology. Focus on Weight Decrease with a systemic impact of 34.0%.
R2025_190,Coding_Addition,Oncology,Weight Shift,0.84,2025 Coding_Addition update for Oncology. Focus on Weight Shift with a systemic impact of 84.0%.
R2025_191,Quality_Penalty,Orthopedics,APC Bundling,0.16,2025 Quality_Penalty update for Orthopedics. Focus on APC Bundling with a systemic impact of 16.0%.
R2025_192,Quality_Penalty,Oncology,Reclassification,0.62,2025 Quality_Penalty update for Oncology. Focus on Reclassification with a systemic impact of 62.0%.
R2025_193,HCC_Revisions,Urology,New CPT Codes,0.84,2025 HCC_Revisions update for Urology. Focus on New CPT Codes with a systemic impact of 84.0%.
R2025_194,Quality_Penalty,Cardiology,Rate Standardization,0.91,2025 Quality_Penalty update for Cardiology. Focus on Rate Standardization with a systemic impact of 91.0%.
R2025_195,OPPS_Bundling,Nephrology,Weight Shift,0.35,2025 OPPS_Bundling update for Nephrology. Focus on Weight Shift with a systemic impact of 35.0%.
R2025_196,Coding_Addition,Urology,Rate Standardization,0.81,2025 Coding_Addition update for Urology. Focus on Rate Standardization with a systemic impact of 81.0%.
R2025_197,CC_MCC_Update,Orthopedics,New CPT Codes,0.8,2025 CC_MCC_Update update for Orthopedics. Focus on New CPT Codes with a systemic impact of 80.0%.
R2025_198,Quality_Penalty,Nephrology,New CPT Codes,0.49,2025 Quality_Penalty update for Nephrology. Focus on New CPT Codes with a systemic impact of 49.0%.
R2025_199,Coding_Addition,Oncology,New CPT Codes,0.61,2025 Coding_Addition update for Oncology. Focus on New CPT Codes with a systemic impact of 61.0%.
R2025_200,Coding_Addition,Nephrology,Penalty Increase,0.11,2025 Coding_Addition update for Nephrology. Focus on Penalty Increase with a systemic impact of 11.0%.
R2025_201,Coding_Addition,Oncology,Weight Decrease,0.62,2025 Coding_Addition update for Oncology. Focus on Weight Decrease with a systemic impact of 62.0%.
R2025_202,Coding_Addition,Internal Medicine,Reclassification,0.81,2025 Coding_Addition update for Internal Medicine. Focus on Reclassification with a systemic impact of 81.0%.
R2025_203,HCC_Revisions,General Surgery,Coverage Determination,0.85,2025 HCC_Revisions update for General Surgery. Focus on Coverage Determination with a systemic impact of 85.0%.
R2025_204,CC_MCC_Update,Orthopedics,Weight Increase,0.4,2025 CC_MCC_Update update for Orthopedics. Focus on Weight Increase with a systemic impact of 40.0%.
R2025_205,Quality_Penalty,Internal Medicine,New CPT Codes,0.68,2025 Quality_Penalty update for Internal Medicine. Focus on New CPT Codes with a systemic impact of 68.0%.
R2025_206,NCD_LCD_Update,Endocrinology,Weight Shift,0.56,2025 NCD_LCD_Update update for Endocrinology. Focus on Weight Shift with a systemic impact of 56.00000000000001%.
R2025_207,OPPS_Bundling,Orthopedics,Penalty Increase,0.34,2025 OPPS_Bundling update for Orthopedics. Focus on Penalty Increase with a systemic impact of 34.0%.
R2025_208,DRG_Logic,Internal Medicine,Weight Increase,0.42,2025 DRG_Logic update for Internal Medicine. Focus on Weight Increase with a systemic impact of 42.0%.
R2025_209,Value_Based_Program,Cardiology,Weight Shift,0.44,2025 Value_Based_Program update for Cardiology. Focus on Weight Shift with a systemic impact of 44.0%.
R2025_210,Telehealth,Orthopedics,Readmission Adjustment,0.21,2025 Telehealth update for Orthopedics. Focus on Readmission Adjustment with a systemic impact of 21.0%.
R2025_211,Site_of_Care,Gastroenterology,Rate Standardization,0.52,2025 Site_of_Care update for Gastroenterology. Focus on Rate Standardization with a systemic impact of 52.0%.
R2025_212,Payment_Policy,Pulmonology,Rate Standardization,0.47,2025 Payment_Policy update for Pulmonology. Focus on Rate Standardization with a systemic impact of 47.0%.
R2025_213,Value_Based_Program,Pulmonology,New CPT Codes,0.4,2025 Value_Based_Program update for Pulmonology. Focus on New CPT Codes with a systemic impact of 40.0%.
R2025_214,DRG_Logic,Internal Medicine,Reclassification,0.87,2025 DRG_Logic update for Internal Medicine. Focus on Reclassification with a systemic impact of 87.0%.
R2025_215,OPPS_Bundling,Neurology,Weight Increase,0.58,2025 OPPS_Bundling update for Neurology. Focus on Weight Increase with a systemic impact of 57.99999999999999%.
R2025_216,Value_Based_Program,Internal Medicine,Readmission Adjustment,0.19,2025 Value_Based_Program update for Internal Medicine. Focus on Readmission Adjustment with a systemic impact of 19.0%.
R2025_217,Coding_Addition,Orthopedics,Weight Increase,0.38,2025 Coding_Addition update for Orthopedics. Focus on Weight Increase with a systemic impact of 38.0%.
R2025_218,Payment_Policy,Cardiology,Reclassification,0.53,2025 Payment_Policy update for Cardiology. Focus on Reclassification with a systemic impact of 53.0%.
R2025_219,Quality_Penalty,Neurology,Inclusion Shift,0.39,2025 Quality_Penalty update for Neurology. Focus on Inclusion Shift with a systemic impact of 39.0%.
R2025_220,Telehealth,Cardiology,Coverage Determination,0.89,2025 Telehealth update for Cardiology. Focus on Coverage Determination with a systemic impact of 89.0%.
R2025_221,NCD_LCD_Update,Nephrology,Site-of-care shift,0.58,2025 NCD_LCD_Update update for Nephrology. Focus on Site-of-care shift with a systemic impact of 57.99999999999999%.
R2025_222,Site_of_Care,Oncology,Weight Increase,0.7,2025 Site_of_Care update for Oncology. Focus on Weight Increase with a systemic impact of 70.0%.
R2025_223,Payment_Policy,Oncology,Inclusion Shift,0.87,2025 Payment_Policy update for Oncology. Focus on Inclusion Shift with a systemic impact of 87.0%.
R2025_224,Coding_Addition,Cardiology,Inclusion Shift,0.79,2025 Coding_Addition update for Cardiology. Focus on Inclusion Shift with a systemic impact of 79.0%.
R2025_225,Site_of_Care,Internal Medicine,Readmission Adjustment,0.9,2025 Site_of_Care update for Internal Medicine. Focus on Readmission Adjustment with a systemic impact of 90.0%.
R2025_226,HCC_Revisions,Gastroenterology,Reclassification,0.35,2025 HCC_Revisions update for Gastroenterology. Focus on Reclassification with a systemic impact of 35.0%.
R2025_227,Coding_Addition,Gastroenterology,Readmission Adjustment,0.51,2025 Coding_Addition update for Gastroenterology. Focus on Readmission Adjustment with a systemic impact of 51.0%.
R2025_228,Value_Based_Program,Neurology,Weight Increase,0.12,2025 Value_Based_Program update for Neurology. Focus on Weight Increase with a systemic impact of 12.0%.
R2025_229,Quality_Penalty,Endocrinology,Rate Standardization,0.89,2025 Quality_Penalty update for Endocrinology. Focus on Rate Standardization with a systemic impact of 89.0%.
R2025_230,Telehealth,Pulmonology,Inclusion Shift,0.8,2025 Telehealth update for Pulmonology. Focus on Inclusion Shift with a systemic impact of 80.0%.
R2025_231,Site_of_Care,Internal Medicine,Weight Shift,0.23,2025 Site_of_Care update for Internal Medicine. Focus on Weight Shift with a systemic impact of 23.0%.
R2025_232,OPPS_Bundling,Oncology,Weight Increase,0.34,2025 OPPS_Bundling update for Oncology. Focus on Weight Increase with a systemic impact of 34.0%.
R2025_233,Telehealth,Gastroenterology,Weight Shift,0.93,2025 Telehealth update for Gastroenterology. Focus on Weight Shift with a systemic impact of 93.0%.
R2025_234,Payment_Policy,Oncology,APC Bundling,0.76,2025 Payment_Policy update for Oncology. Focus on APC Bundling with a systemic impact of 76.0%.
R2025_235,Quality_Penalty,Pulmonology,Reclassification,0.64,2025 Quality_Penalty update for Pulmonology. Focus on Reclassification with a systemic impact of 64.0%.
R2025_236,Site_of_Care,Oncology,Weight Decrease,0.17,2025 Site_of_Care update for Oncology. Focus on Weight Decrease with a systemic impact of 17.0%.
R2025_237,Value_Based_Program,Pulmonology,Site-of-care shift,0.19,2025 Value_Based_Program update for Pulmonology. Focus on Site-of-care shift with a systemic impact of 19.0%.
R2025_238,HCC_Revisions,Neurology,APC Bundling,0.63,2025 HCC_Revisions update for Neurology. Focus on APC Bundling with a systemic impact of 63.0%.
R2025_239,OPPS_Bundling,Pulmonology,Readmission Adjustment,0.76,2025 OPPS_Bundling update for Pulmonology. Focus on Readmission Adjustment with a systemic impact of 76.0%.
R2025_240,Telehealth,Cardiology,APC Bundling,0.86,2025 Telehealth update for Cardiology. Focus on APC Bundling with a systemic impact of 86.0%.
R2025_241,DRG_Logic,Urology,Reclassification,0.17,2025 DRG_Logic update for Urology. Focus on Reclassification with a systemic impact of 17.0%.
R2025_242,Coding_Addition,Internal Medicine,Penalty Increase,0.85,2025 Coding_Addition update for Internal Medicine. Focus on Penalty Increase with a systemic impact of 85.0%.
R2025_243,Site_of_Care,Orthopedics,Coverage Determination,0.34,2025 Site_of_Care update for Orthopedics. Focus on Coverage Determination with a systemic impact of 34.0%.
R2025_244,Value_Based_Program,Pulmonology,New CPT Codes,0.39,2025 Value_Based_Program update for Pulmonology. Focus on New CPT Codes with a systemic impact of 39.0%.
R2025_245,Site_of_Care,Internal Medicine,Site-of-care shift,0.29,2025 Site_of_Care update for Internal Medicine. Focus on Site-of-care shift with a systemic impact of 28.999999999999996%.
R2025_246,Quality_Penalty,Cardiology,Inclusion Shift,0.62,2025 Quality_Penalty update for Cardiology. Focus on Inclusion Shift with a systemic impact of 62.0%.
R2025_247,DRG_Logic,Nephrology,Penalty Increase,0.87,2025 DRG_Logic update for Nephrology. Focus on Penalty Increase with a systemic impact of 87.0%.
R2025_248,CC_MCC_Update,Orthopedics,Weight Decrease,0.13,2025 CC_MCC_Update update for Orthopedics. Focus on Weight Decrease with a systemic impact of 13.0%.
R2025_249,Quality_Penalty,Orthopedics,Site-of-care shift,0.54,2025 Quality_Penalty update for Orthopedics. Focus on Site-of-care shift with a systemic impact of 54.0%.
R2025_250,DRG_Logic,Pulmonology,Weight Decrease,0.35,2025 DRG_Logic update for Pulmonology. Focus on Weight Decrease with a systemic impact of 35.0%.
R2025_251,Coding_Addition,Pulmonology,Reclassification,0.57,2025 Coding_Addition update for Pulmonology. Focus on Reclassification with a systemic impact of 56.99999999999999%.
R2025_252,Value_Based_Program,Neurology,Inclusion Shift,0.5,2025 Value_Based_Program update for Neurology. Focus on Inclusion Shift with a systemic impact of 50.0%.
R2025_253,Quality_Penalty,Internal Medicine,Reclassification,0.33,2025 Quality_Penalty update for Internal Medicine. Focus on Reclassification with a systemic impact of 33.0%.
R2025_254,OPPS_Bundling,Pulmonology,APC Bundling,0.23,2025 OPPS_Bundling update for Pulmonology. Focus on APC Bundling with a systemic impact of 23.0%.
R2025_255,CC_MCC_Update,Neurology,Weight Increase,0.65,2025 CC_MCC_Update update for Neurology. Focus on Weight Increase with a systemic impact of 65.0%.
R2025_256,CC_MCC_Update,Orthopedics,New CPT Codes,0.16,2025 CC_MCC_Update update for Orthopedics. Focus on New CPT Codes with a systemic impact of 16.0%.
R2025_257,Value_Based_Program,Urology,Inclusion Shift,0.18,2025 Value_Based_Program update for Urology. Focus on Inclusion Shift with a systemic impact of 18.0%.
R2025_258,OPPS_Bundling,Urology,Coverage Determination,0.33,2025 OPPS_Bundling update for Urology. Focus on Coverage Determination with a systemic impact of 33.0%.
R2025_259,Value_Based_Program,Endocrinology,Rate Standardization,0.83,2025 Value_Based_Program update for Endocrinology. Focus on Rate Standardization with a systemic impact of 83.0%.
R2025_260,HCC_Revisions,Urology,Site-of-care shift,0.12,2025 HCC_Revisions update for Urology. Focus on Site-of-care shift with a systemic impact of 12.0%.
R2025_261,Telehealth,General Surgery,Rate Standardization,0.46,2025 Telehealth update for General Surgery. Focus on Rate Standardization with a systemic impact of 46.0%.
R2025_262,NCD_LCD_Update,Oncology,Inclusion Shift,0.19,2025 NCD_LCD_Update update for Oncology. Focus on Inclusion Shift with a systemic impact of 19.0%.
R2025_263,Site_of_Care,Oncology,APC Bundling,0.34,2025 Site_of_Care update for Oncology. Focus on APC Bundling with a systemic impact of 34.0%.
R2025_264,Payment_Policy,Internal Medicine,Coverage Determination,0.48,2025 Payment_Policy update for Internal Medicine. Focus on Coverage Determination with a systemic impact of 48.0%.
R2025_265,DRG_Logic,Internal Medicine,Penalty Increase,0.2,2025 DRG_Logic update for Internal Medicine. Focus on Penalty Increase with a systemic impact of 20.0%.
R2025_266,NCD_LCD_Update,General Surgery,Weight Increase,0.3,2025 NCD_LCD_Update update for General Surgery. Focus on Weight Increase with a systemic impact of 30.0%.
R2025_267,Coding_Addition,Orthopedics,New CPT Codes,0.46,2025 Coding_Addition update for Orthopedics. Focus on New CPT Codes with a systemic impact of 46.0%.
R2025_268,Quality_Penalty,Oncology,Coverage Determination,0.24,2025 Quality_Penalty update for Oncology. Focus on Coverage Determination with a systemic impact of 24.0%.
R2025_269,Quality_Penalty,Urology,New CPT Codes,0.14,2025 Quality_Penalty update for Urology. Focus on New CPT Codes with a systemic impact of 14.000000000000002%.
R2025_270,Payment_Policy,Orthopedics,Reclassification,0.79,2025 Payment_Policy update for Orthopedics. Focus on Reclassification with a systemic impact of 79.0%.
R2025_271,Payment_Policy,General Surgery,Site-of-care shift,0.14,2025 Payment_Policy update for General Surgery. Focus on Site-of-care shift with a systemic impact of 14.000000000000002%.
R2025_272,Telehealth,General Surgery,New CPT Codes,0.41,2025 Telehealth update for General Surgery. Focus on New CPT Codes with a systemic impact of 41.0%.
R2025_273,Site_of_Care,Urology,Site-of-care shift,0.56,2025 Site_of_Care update for Urology. Focus on Site-of-care shift with a systemic impact of 56.00000000000001%.
R2025_274,OPPS_Bundling,Neurology,Penalty Increase,0.79,2025 OPPS_Bundling update for Neurology. Focus on Penalty Increase with a systemic impact of 79.0%.
R2025_275,CC_MCC_Update,Oncology,Penalty Increase,0.54,2025 CC_MCC_Update update for Oncology. Focus on Penalty Increase with a systemic impact of 54.0%.
R2025_276,NCD_LCD_Update,Cardiology,Readmission Adjustment,0.94,2025 NCD_LCD_Update update for Cardiology. Focus on Readmission Adjustment with a systemic impact of 94.0%.
R2025_277,NCD_LCD_Update,Urology,Weight Shift,0.6,2025 NCD_LCD_Update update for Urology. Focus on Weight Shift with a systemic impact of 60.0%.
R2025_278,NCD_LCD_Update,Gastroenterology,Reclassification,0.24,2025 NCD_LCD_Update update for Gastroenterology. Focus on Reclassification with a systemic impact of 24.0%.
R2025_279,Site_of_Care,Orthopedics,Readmission Adjustment,0.21,2025 Site_of_Care update for Orthopedics. Focus on Readmission Adjustment with a systemic impact of 21.0%.
R2025_280,OPPS_Bundling,Nephrology,Reclassification,0.61,2025 OPPS_Bundling update for Nephrology. Focus on Reclassification with a systemic impact of 61.0%.
R2025_281,HCC_Revisions,Urology,Site-of-care shift,0.82,2025 HCC_Revisions update for Urology. Focus on Site-of-care shift with a systemic impact of 82.0%.
R2025_282,HCC_Revisions,Cardiology,Reclassification,0.91,2025 HCC_Revisions update for Cardiology. Focus on Reclassification with a systemic impact of 91.0%.
R2025_283,NCD_LCD_Update,Gastroenterology,Weight Increase,0.79,2025 NCD_LCD_Update update for Gastroenterology. Focus on Weight Increase with a systemic impact of 79.0%.
R2025_284,DRG_Logic,General Surgery,Readmission Adjustment,0.36,2025 DRG_Logic update for General Surgery. Focus on Readmission Adjustment with a systemic impact of 36.0%.
R2025_285,Payment_Policy,Endocrinology,Weight Increase,0.95,2025 Payment_Policy update for Endocrinology. Focus on Weight Increase with a systemic impact of 95.0%.
R2025_286,NCD_LCD_Update,Urology,Rate Standardization,0.6,2025 NCD_LCD_Update update for Urology. Focus on Rate Standardization with a systemic impact of 60.0%.
R2025_287,Value_Based_Program,Gastroenterology,Penalty Increase,0.91,2025 Value_Based_Program update for Gastroenterology. Focus on Penalty Increase with a systemic impact of 91.0%.
R2025_288,Telehealth,Cardiology,Penalty Increase,0.59,2025 Telehealth update for Cardiology. Focus on Penalty Increase with a systemic impact of 59.0%.
R2025_289,NCD_LCD_Update,Urology,Weight Decrease,0.84,2025 NCD_LCD_Update update for Urology. Focus on Weight Decrease with a systemic impact of 84.0%.
R2025_290,Coding_Addition,Endocrinology,Coverage Determination,0.48,2025 Coding_Addition update for Endocrinology. Focus on Coverage Determination with a systemic impact of 48.0%.
R2025_291,Value_Based_Program,Pulmonology,Site-of-care shift,0.46,2025 Value_Based_Program update for Pulmonology. Focus on Site-of-care shift with a systemic impact of 46.0%.
R2025_292,HCC_Revisions,General Surgery,Weight Decrease,0.31,2025 HCC_Revisions update for General Surgery. Focus on Weight Decrease with a systemic impact of 31.0%.
R2025_293,NCD_LCD_Update,Endocrinology,APC Bundling,0.72,2025 NCD_LCD_Update update for Endocrinology. Focus on APC Bundling with a systemic impact of 72.0%.
R2025_294,DRG_Logic,Pulmonology,Penalty Increase,0.65,2025 DRG_Logic update for Pulmonology. Focus on Penalty Increase with a systemic impact of 65.0%.
R2025_295,Payment_Policy,Oncology,APC Bundling,0.79,2025 Payment_Policy update for Oncology. Focus on APC Bundling with a systemic impact of 79.0%.
R2025_296,Coding_Addition,Neurology,Readmission Adjustment,0.3,2025 Coding_Addition update for Neurology. Focus on Readmission Adjustment with a systemic impact of 30.0%.
R2025_297,NCD_LCD_Update,Endocrinology,Weight Shift,0.61,2025 NCD_LCD_Update update for Endocrinology. Focus on Weight Shift with a systemic impact of 61.0%.
R2025_298,HCC_Revisions,Cardiology,Rate Standardization,0.59,2025 HCC_Revisions update for Cardiology. Focus on Rate Standardization with a systemic impact of 59.0%.
R2025_299,Payment_Policy,General Surgery,Weight Increase,0.17,2025 Payment_Policy update for General Surgery. Focus on Weight Increase with a systemic impact of 17.0%.
R2025_300,OPPS_Bundling,Oncology,Rate Standardization,0.76,2025 OPPS_Bundling update for Oncology. Focus on Rate Standardization with a systemic impact of 76.0%.
R2025_301,Site_of_Care,Orthopedics,Readmission Adjustment,0.29,2025 Site_of_Care update for Orthopedics. Focus on Readmission Adjustment with a systemic impact of 28.999999999999996%.
R2025_302,Payment_Policy,General Surgery,Site-of-care shift,0.1,2025 Payment_Policy update for General Surgery. Focus on Site-of-care shift with a systemic impact of 10.0%.
R2025_303,Coding_Addition,Orthopedics,Penalty Increase,0.87,2025 Coding_Addition update for Orthopedics. Focus on Penalty Increase with a systemic impact of 87.0%.
R2025_304,DRG_Logic,Cardiology,New CPT Codes,0.36,2025 DRG_Logic update for Cardiology. Focus on New CPT Codes with a systemic impact of 36.0%.
R2025_305,Telehealth,Urology,Weight Increase,0.42,2025 Telehealth update for Urology. Focus on Weight Increase with a systemic impact of 42.0%.
R2025_306,Site_of_Care,Gastroenterology,Weight Increase,0.31,2025 Site_of_Care update for Gastroenterology. Focus on Weight Increase with a systemic impact of 31.0%.
R2025_307,Site_of_Care,Endocrinology,Inclusion Shift,0.34,2025 Site_of_Care update for Endocrinology. Focus on Inclusion Shift with a systemic impact of 34.0%.
R2025_308,Payment_Policy,General Surgery,Weight Increase,0.28,2025 Payment_Policy update for General Surgery. Focus on Weight Increase with a systemic impact of 28.000000000000004%.
R2025_309,Telehealth,Gastroenterology,APC Bundling,0.34,2025 Telehealth update for Gastroenterology. Focus on APC Bundling with a systemic impact of 34.0%.
R2025_310,Site_of_Care,Gastroenterology,Inclusion Shift,0.66,2025 Site_of_Care update for Gastroenterology. Focus on Inclusion Shift with a systemic impact of 66.0%.
R2025_311,OPPS_Bundling,Pulmonology,APC Bundling,0.36,2025 OPPS_Bundling update for Pulmonology. Focus on APC Bundling with a systemic impact of 36.0%.
R2025_312,OPPS_Bundling,Gastroenterology,Weight Shift,0.44,2025 OPPS_Bundling update for Gastroenterology. Focus on Weight Shift with a systemic impact of 44.0%.
R2025_313,Site_of_Care,Gastroenterology,Penalty Increase,0.82,2025 Site_of_Care update for Gastroenterology. Focus on Penalty Increase with a systemic impact of 82.0%.
R2025_314,Quality_Penalty,Internal Medicine,Weight Shift,0.64,2025 Quality_Penalty update for Internal Medicine. Focus on Weight Shift with a systemic impact of 64.0%.
R2025_315,Value_Based_Program,Internal Medicine,Weight Decrease,0.18,2025 Value_Based_Program update for Internal Medicine. Focus on Weight Decrease with a systemic impact of 18.0%.
R2025_316,OPPS_Bundling,Oncology,Site-of-care shift,0.51,2025 OPPS_Bundling update for Oncology. Focus on Site-of-care shift with a systemic impact of 51.0%.
R2025_317,Quality_Penalty,Gastroenterology,Weight Increase,0.19,2025 Quality_Penalty update for Gastroenterology. Focus on Weight Increase with a systemic impact of 19.0%.
R2025_318,Site_of_Care,Nephrology,Penalty Increase,0.49,2025 Site_of_Care update for Nephrology. Focus on Penalty Increase with a systemic impact of 49.0%.
R2025_319,Quality_Penalty,Neurology,Weight Decrease,0.73,2025 Quality_Penalty update for Neurology. Focus on Weight Decrease with a systemic impact of 73.0%.
R2025_320,Coding_Addition,Neurology,Weight Decrease,0.53,2025 Coding_Addition update for Neurology. Focus on Weight Decrease with a systemic impact of 53.0%.
R2025_321,Value_Based_Program,Neurology,Site-of-care shift,0.55,2025 Value_Based_Program update for Neurology. Focus on Site-of-care shift with a systemic impact of 55.00000000000001%.
R2025_322,DRG_Logic,Neurology,Rate Standardization,0.81,2025 DRG_Logic update for Neurology. Focus on Rate Standardization with a systemic impact of 81.0%.
R2025_323,Site_of_Care,Cardiology,Inclusion Shift,0.31,2025 Site_of_Care update for Cardiology. Focus on Inclusion Shift with a systemic impact of 31.0%.
R2025_324,Site_of_Care,Neurology,Readmission Adjustment,0.64,2025 Site_of_Care update for Neurology. Focus on Readmission Adjustment with a systemic impact of 64.0%.
R2025_325,Coding_Addition,Cardiology,New CPT Codes,0.5,2025 Coding_Addition update for Cardiology. Focus on New CPT Codes with a systemic impact of 50.0%.
R2025_326,CC_MCC_Update,General Surgery,Weight Decrease,0.87,2025 CC_MCC_Update update for General Surgery. Focus on Weight Decrease with a systemic impact of 87.0%.
R2025_327,Payment_Policy,Internal Medicine,New CPT Codes,0.56,2025 Payment_Policy update for Internal Medicine. Focus on New CPT Codes with a systemic impact of 56.00000000000001%.
R2025_328,DRG_Logic,Urology,Penalty Increase,0.31,2025 DRG_Logic update for Urology. Focus on Penalty Increase with a systemic impact of 31.0%.
R2025_329,Telehealth,Urology,Weight Shift,0.34,2025 Telehealth update for Urology. Focus on Weight Shift with a systemic impact of 34.0%.
R2025_330,DRG_Logic,Internal Medicine,Coverage Determination,0.77,2025 DRG_Logic update for Internal Medicine. Focus on Coverage Determination with a systemic impact of 77.0%.
R2025_331,OPPS_Bundling,Cardiology,Weight Increase,0.24,2025 OPPS_Bundling update for Cardiology. Focus on Weight Increase with a systemic impact of 24.0%.
R2025_332,Quality_Penalty,General Surgery,Site-of-care shift,0.39,2025 Quality_Penalty update for General Surgery. Focus on Site-of-care shift with a systemic impact of 39.0%.
R2025_333,HCC_Revisions,Cardiology,Rate Standardization,0.16,2025 HCC_Revisions update for Cardiology. Focus on Rate Standardization with a systemic impact of 16.0%.
R2025_334,HCC_Revisions,Urology,Rate Standardization,0.59,2025 HCC_Revisions update for Urology. Focus on Rate Standardization with a systemic impact of 59.0%.
R2025_335,HCC_Revisions,Pulmonology,Weight Decrease,0.91,2025 HCC_Revisions update for Pulmonology. Focus on Weight Decrease with a systemic impact of 91.0%.
R2025_336,OPPS_Bundling,Nephrology,APC Bundling,0.92,2025 OPPS_Bundling update for Nephrology. Focus on APC Bundling with a systemic impact of 92.0%.
R2025_337,Telehealth,Pulmonology,Rate Standardization,0.43,2025 Telehealth update for Pulmonology. Focus on Rate Standardization with a systemic impact of 43.0%.
R2025_338,Telehealth,Gastroenterology,Readmission Adjustment,0.22,2025 Telehealth update for Gastroenterology. Focus on Readmission Adjustment with a systemic impact of 22.0%.
R2025_339,DRG_Logic,Pulmonology,Readmission Adjustment,0.31,2025 DRG_Logic update for Pulmonology. Focus on Readmission Adjustment with a systemic impact of 31.0%.
R2025_340,Quality_Penalty,Urology,New CPT Codes,0.44,2025 Quality_Penalty update for Urology. Focus on New CPT Codes with a systemic impact of 44.0%.
R2025_341,OPPS_Bundling,Cardiology,Weight Shift,0.53,2025 OPPS_Bundling update for Cardiology. Focus on Weight Shift with a systemic impact of 53.0%.
R2025_342,Quality_Penalty,Pulmonology,Coverage Determination,0.4,2025 Quality_Penalty update for Pulmonology. Focus on Coverage Determination with a systemic impact of 40.0%.
R2025_343,Coding_Addition,Nephrology,Penalty Increase,0.39,2025 Coding_Addition update for Nephrology. Focus on Penalty Increase with a systemic impact of 39.0%.