January 2, 2026

In this episode, Scott, Mark, and Dr. John Lin dive into the complexities of billing G2211, the Medicare add-on code for complex E/M visits, which now pays nearly $18 per use. They unpack a real-world case where a hospital system’s blanket use of modifier 25 is preventing employed physicians from getting reimbursed for G2211, potentially costing them thousands in RVUs. The discussion covers payer-specific rules, how to appeal inappropriate denials, how contract structure affects physician compensation, and when to fight for carve-outs. They also explore why every urology practice should reassess payer mix and drop underperforming contracts when appropriate.

Urology Advanced Coding and Reimbursement Seminar

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PRS Coding and Reimbursement Hub

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Free Kidney Stone Coding Calculator

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PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

PRS Billing and Other Services - Book a Call with Mark Painter or
Marianne Desciose

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Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/

December 26, 2025

In this episode, Scott, Mark, and Ray Painter answer listener questions about the new 2026 prostate biopsy CPT codes. They clarify global periods, explain the differences between transrectal and transperineal approaches, and tackle the nuances of coding for MRI-guided procedures—especially when using systems like Promaxo. They also break down the use of 55715 for additional targeted lesions, when modifiers like 52 may apply, and how payers might interpret these new codes differently. The team emphasizes caution, payer communication, and the evolving nature of both coding and coverage guidance.

Urology Advanced Coding and Reimbursement Seminar

Information and Registration

PRS Coding and Reimbursement Hub

Access the Hub

Free Kidney Stone Coding Calculator

Download Now

PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

PRS Billing and Other Services - Book a Call with Mark Painter or
Marianne Desciose

Click Here to Get More Information and Request a Quote

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

December 12, 2025

In this episode, Scott, Mark, and Ray Painter share highlights from the recent Urology Advanced Coding and Reimbursement Seminar in Las Vegas, including robust discussions on E/M coding, prostate biopsy changes, modifiers, and the Wiser program. They also provide an important update on the AMA’s recent meeting about coding and payment for algorithmic services, detailing how CPT and the RUC are approaching AI integration in healthcare. From potential reimbursement models to risk assignment and FDA considerations, this forward-looking conversation covers the groundwork being laid for AI’s role in clinical care and payment policy.

Urology Advanced Coding and Reimbursement Seminar

Information and Registration

PRS Coding and Reimbursement Hub

Access the Hub

Free Kidney Stone Coding Calculator

Download Now

PRS Coding Courses

For Urologist

For APPs

For Coders, Billers, and Admins

PRS Billing and Other Services - Book a Call with Mark Painter or
Marianne Desciose

Click Here to Get More Information and Request a Quote

Join the Urology Pharma and Tech Pioneer Group

Empowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.

https://www.prsnetwork.com/joinuptp

Click Here to Start Your Free Trial of AUACodingToday.com

The Thriving Urology Practice Facebook group.

The Thriving Urology Practice Facebook Group link to join:

https://www.facebook.com/groups/ThrivingPractice/