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CMS Policy Changes to Reduce Costs Financial pressures are rising as CMS implements the updated Version 28 Hierarchical Condition Category (HCC) model , which introduces changes aimed at limiting types of codes that are most used for up-coding or over-coding to help rein in spending. We call them CMS 4201 violations.
The publication of the Neighbourhood Health Guidelines for 2025/26 has once again left general practice in the dark. Digital solutions such as remote monitoring and patient-initiated follow-up are also being promoted as ways to improve access and reduce unnecessary appointments.
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