On January 1, 2026, Medicare cut skin substitute pay ~90% to a flat $127.14/cm². What survives for plastic surgery and dermatology — and what doesn’t.

The Core Problem: One Code, Many Techniques The technique changes depending on the patient. The CPT code doesn’t. For top surgery — augmentation, reduction, mastectomy with nipple reconstruction — reimbursement is tied to the standard diagnosis for that procedure type. A reduction for macromasty and a reduction for masculinization carry the same code, same reimbursement, […]

In plastic surgery billing, accounts receivable, often referred to as AR, rarely deteriorates overnight. More often, AR slowly drifts. Denials increase, aging stretches out, cash flow tightens, and leadership assumes it is a payer issue. AR is a slow burn… once you notice a fire is it often too late or at least you’ve lost […]

Denials in Medical Billing: Causes, Codes, and How to Fix Them Every denied medical claim costs time, money, and resources.  Denials in medical billing can disrupt cash flow, increase administrative work, and leave patients frustrated when services aren’t covered as expected. Recent studies show that nearly 12% of medical claims are initially denied, and hospitals […]

How Do I Bill with Confidence? Mastering Documentation and Insurance Verification Let’s face it—medical billing is a game of paperwork roulette. Miss one detail, and you’re stuck dealing with denials, delays, or worse, an audit. But here’s the good news: with the right strategies, you can dodge common billing pitfalls and keep your revenue flowing […]

6 Tips To Maximize Revenue in a Dermatology Clinic Running a dermatology clinic takes a lot. You’ve got to worry about your staff, patients, payments – there’s a quite a few moving gears! While patient care is always the priority, boosting your clinic’s revenue is key to staying competitive and growing. The good news is, […]

Tips on Maximizing Revenue in a Plastic Surgery Clinic Running a successful plastic surgery clinic requires more than just medical expertise – it also demands savvy business practices. To make sure your clinic is thriving financially, you need strategies that boost revenue without dropping the quality of care… Here are some effective tips to help […]

1. Women’s Health Rights and Cancer Act – you are protected folks.  This is a Federal Mandate.  So all the games insurance companies play hold even less water here.  You are protected for reconstruction (or not) at ALL STAGES including the contralateral breast.  The language of the mandate doesn’t answer every question or address every […]

THE QUESTION: THE PATIENT HAD TOLD ME THEY’RE OK MOVING FORWARD COSMETIC AND HAVE NOW BILLED THE INSURANCE COMPANY ON THE BACKEND, FORCING US INTO THE BILLING PROCESS. ANY WAY TO AVOID THIS IN FUTURE? We were asked a really good question about insulating against patients submitting self-pay cases to their insurance after the fact- […]

WHICH PLASTIC SURGERY PROCEDURES ACTUALLY PAY (THROUGH INSURANCE)? As a plastic surgeon, it’s likely that you got into this field because you like to help people.  But, realistically, you can’t help every person that walks through your doors and still keep the lights on. To run a successful practice, you have to keep an eye […]