UnitedHealthcare Drops Prior Authorization on 1,700 Codes: What Urgent Care Needs to Know
What Did UnitedHealthcare Change on October 1, 2026? As of October 1, 2026, UnitedHealthcare removed prior authorization requirements for approximately 1,700 procedure codes across its commercial, Medicare Advantage, Community, Individual Exchange, and Oxford plans. The change fulfills a commitment UHC made in May 2026 to cut prior authorization volume by 30% before year end, but […]
CPT 87880: Rapid Strep A Test Billing Guide (2026)
What Is CPT Code 87880? CPT code 87880 reports a rapid Group A Streptococcus (strep A) antigen test performed by immunoassay with direct visual observation using a throat swab. It is a CLIA-waived test that generally requires modifier QW and is reported as a single unit per encounter. CLIA-waived, QW required: 87880 is CLIA-waived, so […]
Flu Season Billing for Urgent Care: What Changed for 2026 and How to Protect Your Revenue
What Should Urgent Care Centers Know About Flu Season Billing in 2026? As of October 2026, the 2026-2027 respiratory season introduces updated billing requirements for urgent care centers performing flu, COVID-19, and RSV testing and treatment. CPT code 87812, which took effect January 1, 2026, is now the required code for combo COVID/flu rapid tests, […]
ICD-10 Code R10.9: Unspecified Abdominal Pain Billing Guide for Urgent Care
What Is the ICD-10 Code for Unspecified Abdominal Pain? ICD-10-CM code R10.9 is the billable diagnosis code for unspecified abdominal pain, used when a patient presents with abdominal discomfort and the clinical record does not specify the location, cause, or character of the pain. As of FY 2027 (effective October 1, 2026), R10.9 remains valid […]
S9083 vs S9088 in Urgent Care Billing: Global Fee, Add-On, and When to Use Each
What Is the Difference Between S9083 and S9088 in Urgent Care Billing? S9083 and S9088 are HCPCS Level II S-codes used in urgent care billing to capture facility-level costs that standard E/M codes do not cover. As of 2026, S9083 represents a global flat fee that replaces the E/M code entirely for the visit, while […]
October 2026 Medicare Part B Payment Update: What Urgent Care Billing Teams Need to Know
What Changed in the October 2026 Medicare Payment Update? As of October 2026, CMS released the Q4 Medicare Physician Fee Schedule Database (MPFSDB) quarterly update and the October 2026 HCPCS quarterly code file, both effective for claims with dates of service on or after October 1, 2026. The update adds new HCPCS codes, deletes others, […]
POS 20 in Medical Billing: The Urgent Care Facility Code Explained
QUICK ANSWER POS 20 is the place of service code that identifies an urgent care facility on medical claims. The Centers for Medicare and Medicaid Services (CMS) added POS 20 to the national code set on January 1, 2003, to distinguish urgent care visits from office visits (POS 11) and emergency department visits (POS 22 […]
September 2026 Payer Changes That Urgent Care Centers Need to Address Now
What Payer Changes Affect Urgent Care Billing in September 2026? As of September 2026, UnitedHealthcare, Aetna, Blue Cross Blue Shield of Michigan, BCBS Texas, and Molina Healthcare have all implemented billing policy changes that directly affect how urgent care centers submit claims, bill lab tests, and get reimbursed for same-day procedures. These changes include new […]
CPT Code 96372: The Complete 2026 Billing and Reimbursement Guide
What Is CPT Code 96372? CPT code 96372 is the Current Procedural Terminology code used to bill the administration of a therapeutic, prophylactic, or diagnostic injection given subcutaneously or intramuscularly. It covers the act of administering the injection only, not the drug itself, which is billed separately using the appropriate HCPCS J-code. The code applies […]
2027 Medicare Lab Fee Schedule Cuts: What Urgent Care Clinics Need to Know
What Are the 2027 Medicare Lab Fee Schedule Changes for Urgent Care? As of September 2026, CMS has released preliminary 2027 Clinical Laboratory Fee Schedule (CLFS) rates that show an average 16% reduction in Medicare reimbursement for clinical lab tests. The cuts are based on private payor rate data collected under the Protecting Access to […]
