KR2 Medical Billing

KR2 Medical Billing Owned by a Certfied Professional Biller (through AAPC). Conveniently located in Hastings on Hudson, NY.

I currently offer only online medical and billing coding training. Please visit my website kr2billing.com for more information.

MA Common Wealth Alliance: new prior auth req BH servicesIf you are a BH provider that accepts Senior Care Options and O...
09/08/2026

MA Common Wealth Alliance: new prior auth req BH services

If you are a BH provider that accepts Senior Care Options and One Care Behavioral Health members? Then the following blog post is for you! What is changing? For any DOS on or after 09/1/26 there will be a prior notification/prior authorization requirenment for certain BH services Which services are subject to this change? Image via CCA website Image via CCA website…...

If you are a BH provider that accepts Senior Care Options and One Care Behavioral Health members? Then the following blog post is for you! What is changing? For any DOS on or after 09/1/26 there wi…

09/01/2026

Healthfirst: prior auth for codes 10/1/26

If you are a NY provider that accepts Healthfirst members, then the blog post is for you! Starting 10/1/26 there will be new codes that will become effective and will require and auth. Codes that will require an auth through Healthfirst firecty: 0935T CPT-CAT IIICystourethroscopy with renal pelvicsympathetic denervation,radiofrequency ablation, retrograde ureteral approach,including insertion of guide wire, selective placement of…...

If you are a NY provider that accepts Healthfirst members, then the blog post is for you! Starting 10/1/26 there will be new codes that will become effective and will require and auth. Codes that w…

08/30/2026

Aetna: CA HMO provider disputes submission changes

Announcement- if you are a provider that sees California Aetna HMO plan; then effective immediately you should not submit the provider dispute through Availity portal and instead please mail the to folliwing address: P.O. Box 14020Lexington, KY 40512 As per Aetna- Fresno office is closed. Find this information useful? Follow my blog for more!

Announcement- if you are a provider that sees California Aetna HMO plan; then effective immediately you should not submit the provider dispute through Availity portal and instead please mail the t…

NY UHC Community Plan- no payment for 97161-97168 codesIf you are a PT/OT provider in NY and accept UHC Community Health...
08/26/2026

NY UHC Community Plan- no payment for 97161-97168 codes

If you are a PT/OT provider in NY and accept UHC Community Health Plan patients? Then this blog post is for you! What is changing? UHC announced that for any DOS 12/1/26 and thereafter the codes 97161-97168 will be added to their non-covered code list. Coding: 97161-physicical therapy evaluation- low complexity 97162- physical therapy evaluation - medium complexity 97163- high complexity…...

If you are a PT/OT provider in NY and accept UHC Community Health Plan patients? Then this blog post is for you! What is changing? UHC announced that for any DOS 12/1/26 and thereafter the codes 97…

08/26/2026

NM UHC Community plan- avoiding costly denials

If you are a provider in NM that accepts UHC Community Health plan- then this blog post is for you! As of 3/23/26- The New Mexico Health Care Authority (HCA) launched Turquoise Claims, as one system of entry point for fee-for-service claims. With this change came specific changes: Requires claims to he billed with Taxonomy code Taxonomy code needs to correspond to the Provider classification that is on file with NM HCA…...

If you are a provider in NM that accepts UHC Community Health plan- then this blog post is for you! As of 3/23/26- The New Mexico Health Care Authority (HCA) launched Turquoise Claims, as one syste…

08/20/2026

FidelisCare: pre- pay claim review for COB – third party payers

NY Providers- Do you have a patient that has FidelisCare and could potentially have a a case through workers comp or motor vehicle case? Then this blog post is for you! What is new? FidelisCare has partnered with a third party vendor- Machinify- to review claims that maybe due to accidents, injuries The identified claims will be pended for further review to establish the proper primary payer…...

NY Providers- Do you have a patient that has FidelisCare and could potentially have a a case through workers comp or motor vehicle case? Then this blog post is for you! What is new? FidelisCare has…

08/19/2026

UPMC Community Behavioral Health Org: reporting to***co screening services- proper coding and billing

The following codes for To***co Screening apply to all HealthChoice INN providers that are part of Community Care Behavioral Health Org (MCO PA). What was approved n by The PA The Office of Mental Health and Substance Abuse Services (OMHSAS): G codes (listed below) for To***co screening of patients 12 years and older. These services should be done at least yearly, preferably at intake step of the patient visit…...

The following codes for To***co Screening apply to all HealthChoice INN providers that are part of Community Care Behavioral Health Org (MCO PA). What was approved n by The PA The Office of Mental …

08/16/2026

Are you using the proper Anesthesia codes for fascial plane blocks?

In Jan of 2025 there were 6 new codes that became effective, for fascial plane blocks. In addition, there were updates to already existing abdominal fascial plane blocks. Are staying compliant by selecting the proper codes for services performed? What is new? Thoracic Fascial Block new codes: 64466-Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed 64467- by continuous infusion(s), including imaging guidance, when performed…...

In Jan of 2025 there were 6 new codes that became effective, for fascial plane blocks. In addition, there were updates to already existing abdominal fascial plane blocks. Are staying compliant by s…

08/16/2026

HighMark BCBS: reimbursement for massage therapy services

Are you a provider of the following specialties: chiropractor, PT, physiatry, OT? Then this blog post is for you! What is changing? For any DOS 10/26/26 and thereafter massage therapy services (code 97124) will no longer be separately reimbursed when billed by the specialists listed above The massage therapy services will only be reimbursed by massage therapists This change applies to Medicare Advantage and Commercial Plans…...

Are you a provider of the following specialties: chiropractor, PT, physiatry, OT? Then this blog post is for you! What is changing? For any DOS 10/26/26 and thereafter massage therapy services (cod…

08/13/2026

Molina Health: reduce denials MAT OASAS services (NY)

If you are an OASAS provider in NY and provide services to Molina Health plan members, then the following blog post is for you! What has changed? Effective April 1,2026 and thereafter the EM visit rate codes will be zeroed out: 1468 - OASAS - ARTICLE 32 MEDICAL VISIT1471 - OASAS - MMTP MEDICAL VISIT1552 - OASAS APG - ARTICLE 32 CLINIC MEDICAL…...

If you are an OASAS provider in NY and provide services to Molina Health plan members, then the following blog post is for you! What has changed? Effective April 1,2026 and thereafter the EM visit …

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