January 23 , 2026

In this episode, Scott and Mark Painter discuss what the upcoming January 31 deadline means for telehealth coverage under Medicare, including expectations around funding extensions, potential payment delays, and bipartisan support for long-term access. They also introduce the expanded PRS Coding and Reimbursement Hub—an evolving resource offering disease-specific coding guides, product-specific reimbursement tools, prostate biopsy calculators, EOB insights, and more. Designed to help practices stay ahead of payer policy shifts and streamline claims for new technologies, the Hub is positioned to become urology’s go-to coding and reimbursement resource in 2026 and beyond.

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/

January 16, 2026

In this episode, Scott, Mark, and Ray Painter revisit the new prostate biopsy CPT codes and provide a key update on the use of ProMaxo for MRI-guided biopsies. Mark shares recent insights confirming that CPT codes 55713 and 55714 are appropriate for procedures performed with ProMaxo, clearing up previous ambiguity around the “in-bore” language. Then, the team shifts to deductible season challenges, emphasizing front-desk protocols, eligibility verification, patient collections, and how to handle the increased complexity brought on by insurance churn and Medicare Advantage transitions. This episode delivers practical tips for optimizing both coding confidence and cash flow in the new year.

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/

January 9, 2026

In this episode, Scott, Mark, and Ray Painter tackle the growing issue of automated downcoding by commercial payers—where level 4 and 5 E/M visits are silently paid at lower levels without a formal denial. They explain how this tactic evades typical RCM detection, outline steps to flag and appeal these incorrect payments, and emphasize why accurate documentation is more important than ever. From setting up payer-specific protocols to understanding how AI-driven reviews can misinterpret records, this episode offers practical strategies to protect your top line and push back against unjust reimbursement practices.

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/

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

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/

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/

November 21, 2025

In this episode, Scott, Mark, and Ray Painter explore the reimbursement challenges surrounding procedures that may not be covered by insurance, including those considered cosmetic, elective, or medically unnecessary. They discuss how to identify whether a service is reimbursable, when to use ABNs, how different payer rules come into play, and why collecting upfront may be the smartest move. You’ll also hear strategies for handling denials, gray-area procedures, and why knowing the rules—and your contracts—can make all the difference.

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/

November 14, 2025

In this episode, Scott, Mark, and Ray Painter discuss the impact of the government’s recent reopening on telehealth services for Medicare patients. With the new continuing resolution extending COVID-era telehealth flexibilities through January 30, 2026, they break down what this means for billing, coverage, and patient refunds. The team also explores what to watch for if another shutdown looms, how CMS might handle claims from the closure period, and why signs point to telehealth becoming a permanent fixture in Medicare.

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/