[
{
"id": "chg_2026_cf_update",
"type": "cms.conversion_factor",
"severity": "high",
"effective_date": "2026-01-01",
"published_date": "2025-11-15",
"title": "2026 Medicare Conversion Factor: $32.35",
"summary": "CMS finalized the 2026 MPFS with a conversion factor of $32.35, a 2.9% decrease from the 2025 rate of $33.29.",
"impact": "All Medicare MPFS payments decrease. Verify contracted payer rates that reference MPFS.",
"source": "CMS-1784-F",
"affects": ["all_facilities", "mpfs"]
},
{
"id": "chg_cigna_tf_2026q1",
"type": "payer.timely_filing",
"severity": "critical",
"effective_date": "2026-03-01",
"published_date": "2026-01-15",
"title": "Cigna shortens timely filing to 90 days (select plans)",
"summary": "Cigna commercial plans in TX, FL, CA will enforce 90-day timely filing limit, reduced from 180 days, effective March 1, 2026.",
"impact": "Claims for Cigna commercial plans in affected states must be submitted within 90 days of date of service.",
"affects": ["cigna", "TX", "FL", "CA"]
},
{
"id": "chg_ncci_2026q1",
"type": "coding.ncci_edit",
"severity": "medium",
"effective_date": "2026-01-01",
"published_date": "2025-12-20",
"title": "Q1 2026 NCCI edit updates — 47 new code pairs",
"summary": "CMS released Q1 2026 NCCI PTP edits with 47 new code pair bundles. Radiology and surgical sections most affected.",
"impact": "Review affected code pairs. Some previously separately billable services are now bundled.",
"source": "CMS NCCI",
"affects": ["radiology", "surgery", "ncci"]
}
]
