Billing & payment news

Medicare Annual Wellness Visits will remain covered once per calendar year

Medicare Annual Wellness Visits will remain covered once per calendar year

July 22, 2026

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July 2026 billing policy updates

We publish billing policies to offer transparency and help you bill claims more accurately to reduce delays in processing claims, as well as avoid rebilling and additional requests for information.

July 20, 2026

Your payments will be delivered by ECHO starting Sept. 1

As a reminder, on Sept. 1, 2026, you’ll start receiving claim and capitation payments, remittance details and 1099s from ECHO Health Inc., in partnership with Optum Financial. You can now start taking action to establish your payment preferences Optum / ECHO.

July 15, 2026

Chelation therapy policy and billing updates effective Sept. 7

We’ve updated our chelation therapy medical and billing policies to align coverage criteria and claims processing requirements.

June 23, 2026

Important reminders about our new claim dispute process

Earlier this year, we changed our claim dispute process. Here is some important information about the new process.

June 22, 2026

Claim payments could be delayed this week

Due to technical issues, claim payments could be delayed this week.

June 18, 2026

June 2026 billing policy updates

We publish billing policies to offer transparency and help you bill claims more accurately to reduce delays in processing claims, as well as avoid rebilling and additional requests for information.

June 15, 2026

Drug dosing modifier (JW/JZ) edit denying in error

Key Update Claims billed in accordance with the Priority Health Provider Manual (JW/JZ modifier guidance)—with no modifier on line 1—are currently denying inappropriately.

May 26, 2026

Reminder: medical documentation required for billing above MUE limits

When services are billed above the Medically Unlikely Edit (MUE) limit, we require clear, specific medical documentation to support the additional units. Without this detail, claims may be reduced or denied — even when care is clinically appropriate. Documentation must explain why additional units were medically necessary for that specific date of service.

May 22, 2026

Reminder: new payment & RA processes coming Sept. 1

On Sept. 1, 2026*, you’ll start receiving claim and capitation payments, remittance details and 1099s from ECHO Health Inc., in partnership with Optum Financial.

May 20, 2026

05/16/2026: May 2026 billing policy updates

We publish billing policies to offer transparency and help you bill claims more accurately to reduce delays in processing claims, as well as avoid rebilling and additional requests for information.

May 13, 2026

Start using E/M codes for maternity services billing in June

The American Medical Association (AMA) recently announced new obstetric (OB) CPT codes that will replace the bundled, global OB payment for maternity care services, effective Jan. 1, 2027. We encourage providers caring for pregnant women to start using existing E/M codes when billing for patients starting their prenatal visits on / around June 1, 2026.

May 5, 2026