Anthem’s 2026 Reimbursement Changes: What Providers Need to Know

Anthem’s reimbursement policy changes, effective April 1, 2026, will directly impact how providers are paid for preventive services, same-day sick visits, and screening-related care.

If your organization relies on preventive care visits as a consistent revenue stream, these updates aren’t just technical; they’re operational.

Here’s a clear breakdown of what’s changing and what you should be doing now.

Key Takeaway: Same-Day Visits Will Be Paid Differently

One of the most significant updates affects same-day preventive and sick visits under Medicare Advantage plans.

  • Preventive visit: 100% reimbursement
  • Sick visit (same day): 50% reimbursement

To receive reimbursement for the sick visit, Modifier 25 is required, and diagnosis codes must support both services. This also applies to preventive and wellness visit combinations.

Important exception: Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) are excluded from this rule.

Preventive Visits Now Include More Services (Bundled Reimbursement)

For commercial plans, Anthem is expanding what is considered part of a preventive visit — meaning fewer services will be reimbursed separately.

Services now bundled into preventive care include:

  • Counseling services
  • Medical nutrition therapy
  • Screening services
  • Additional other Evaluation & Management (E/M) services
  • Annual gynecological exams
  • Prolonged services
  • Vision screenings

These services are not eligible for separate reimbursement when performed on the same day as a preventive visit.

Does Modifier 25 Still Work? Yes and No

Modifier 25 is often used to indicate a separate, significant E/M service, but its impact is changing.

Yes, it is still required to report a same-day sick visit. No, it will not override bundling rules for services included in preventive care.

Modifier 25 is still necessary, but no longer sufficient to guarantee payment.

What Providers Should Be Doing Now

With these changes now in effect, the focus shifts from preparation to active monitoring and adjustment.

1. Review Recent Claims Activity

Look at claims from April 1 forward:

  • Are same-day visits reimbursing as expected?
  • Are you seeing reductions or denials tied to these policies?

2. Identify Revenue Impact

Take a closer look at how these changes are affecting your bottom line. For example:

  • How often are preventive and sick visits happening on the same day?
  • Are services you previously billed separately now being bundled?
  • Are you receiving less reimbursement for common visit types?

Even a quick review can help you spot trends early.

3. Reinforce Documentation and Coding Practices

Ensure providers and coding teams are aligned on:

  • When Modifier 25 is required
  • When services are no longer separately reimbursable
  • Proper diagnosis coding to support distinct services

4. Adjust Scheduling and Workflow as Needed

If certain visit combinations consistently reduce reimbursement:

  • Reevaluate how appointments are structured
  • Consider whether separating services (when appropriate) makes sense operationally

5. Monitor Denials and Payer Feedback

Track denial trends closely:

  • Are they tied to bundling rules?
  • Are modifiers being rejected?

Use this data to refine processes quickly.

The Bigger Picture: A Shift Toward Bundled Care

These updates are part of a larger trend: payers are redefining what qualifies as a “separate” service.

For providers, that means less reliance on modifiers alone, greater emphasis on documentation, intent, and visit structure, and more coordination across teams.

Final Thoughts

Anthem’s 2026 reimbursement changes aren’t just about coding. They affect how care is scheduled, documented, and reimbursed.

Organizations that proactively adjust workflows and educate their teams will be better positioned to protect revenue, reduce denials, and stay compliant.

If you’re unsure how these updates will impact your practice, now is the time to evaluate your current processes and make adjustments before they take effect. If you have questions about how these updates apply to your organization, our team is here to help you evaluate your processes and identify potential revenue impacts.


What Buyers and Sellers Should Know About Quality of Earnings

Buying or selling a business is rarely just a financial event. It is a defining moment, one that carries opportunity, risk, and significant financial consequences.

The financial statements may show growth. EBITDA may appear strong. But when valuation, negotiations, and capital are on the line, surface-level numbers are not enough.

You need clarity. You need confidence. You need to know the earnings will hold up.

At Harding, Shymanski & Company (HSC), our Quality of Earnings (QoE) services are designed to provide that clarity so you can make critical decisions from a position of strength rather than uncertainty.

What Does a Quality of Earnings Report Really Deliver?

A Quality of Earnings report goes beyond reported results to evaluate the sustainability and reliability of earnings. It identifies what a business truly earns on an ongoing basis — and where potential risks may be hidden.

At HSC, our analyses focus on:

  • Determining whether revenue is recurring and sustainable
  • Evaluating and normalizing EBITDA
  • Assessing working capital requirements
  • Identifying risks such as non-GAAP practices, labor force stability, IT and infrastructure risks, regulatory compliance, etc.
  • Reviewing balance sheet exposures and debt structure
  • Addressing tax considerations when relevant

The objective is not simply to confirm numbers. It is to provide a clear, defensible understanding of earnings power so you can move forward without second-guessing your decisions.

Unverified Earnings = low confidence and high risk. Quality of Earnings Verified Earnings = high confidence and low risk

For Buyers: Protecting Your Investment

When acquiring a business, confidence in the numbers protects more than just price; it protects your capital, your strategy, and your credibility.

Our team evaluates the financial story behind the business to ensure reported performance reflects sustainable operations. We validate EBITDA, assess add-backs, analyze margin trends, and evaluate working capital needs with a transaction-focused lens.

This helps you:

  • Enter negotiations grounded in accurate valuation
  • Identify financial or operational risks before closing
  • Avoid overpaying based on temporary performance
  • Minimize surprises after the deal is complete

We understand how diligence findings affect negotiations and deal structure. Our role is to provide clear, objective insight so you can make informed decisions with confidence.

For Sellers: Protecting the Value You’ve Built

If you are preparing to sell, diligence will test both your numbers and your narrative.

A sell-side Quality of Earnings engagement with HSC allows you to prepare proactively. By identifying adjustments, normalizing earnings, and addressing potential concerns before buyers begin their review, you reduce uncertainty and strengthen credibility.

This preparation helps you:

  • Defend valuation with confidence
  • Reduce the risk of price reductions late in the process
  • Respond to diligence questions without scrambling
  • Maintain momentum and control during negotiations

Preparation reduces stress. It creates stability during a process that can otherwise feel unpredictable. Most importantly, it helps protect the value you’ve worked years to build.

What Sets HSC Apart

Transactions require more than technical accounting expertise. They require steady guidance, thoughtful communication, and a practical understanding of how financial findings impact real-world decisions.

At HSC, we combine:

  • Deep technical knowledge
  • Real transaction experience across industries
  • A business-minded perspective
  • Clear, direct communication throughout the process

We work closely with business owners, private equity groups, investment bankers, lenders, and legal counsel. Our team understands the pressure that accompanies a transaction, and we approach every engagement with professionalism, responsiveness, and discretion.

You will not receive a report in isolation. You will have a team that stays engaged, communicates early, and provides perspective as findings develop.

Our Structured Approach to Quality of Earnings

We follow a disciplined process designed to create clarity without unnecessary disruption:

  1. Define scope and objectives aligned with your transaction goals
  2. Gather and analyze detailed financial information
  3. Identify adjustments, trends, and potential risks
  4. Deliver a clear, well-supported report with actionable insight

Preliminary findings are communicated as they are identified, allowing you to address issues in real time. Most engagements move from initial data request to preliminary results within three to four weeks, depending on complexity.

Our focus is efficiency, transparency, and meaningful insight.

A Trusted Advisor in Critical Moments

A transaction represents a pivotal point in the life of a business. Decisions made during this period can have lasting financial impact.

At HSC, our Quality of Earnings services provide more than analysis. We provide clarity, credibility, and steady guidance when it matters most.

Whether you are evaluating an acquisition, preparing to sell, or bringing in outside investors, we help you move forward with confidence, knowing the numbers are understood, the risks are evaluated, and the path ahead is clear.

If you’re preparing for a transaction or evaluating your options, our team is here to help you understand the numbers and move forward with confidence. Schedule a confidential discussion with our transaction advisory team.


Harding, Shymanski & Company, P.S.C. is an accounting and advisory firm serving companies, nonprofits, and healthcare organizations from offices in Evansville, Indiana, and Louisville, Kentucky. For more than 50 years, we have helped clients across the United States navigate complex tax, accounting, and transaction decisions. Our Transaction Advisory Services team works with buyers and sellers throughout the deal process to identify risks, evaluate earnings quality, and support confident decisions.

2026 Medicare Fee Schedule Updates: Good News for Office-Based Providers, Not So Much for Facility Settings

The 2026 Medicare Physician Fee Schedule (MPFS) updates are sending mixed signals depending on where services are performed.

If your providers primarily see patients in the office, this update likely brings positive news. If a large portion of services are performed in a facility setting (hospital, facility outpatient department, etc.), reimbursement pressure may be increasing.

The Centers for Medicare & Medicaid Services (CMS) released the 2026 Medicare payment updates with adjustments that directly impact physician reimbursement across care settings.

Let’s break it down using some Evaluation & Management services as examples.

Office (Non-Facility) Services: Rates Increased

Across commonly billed office E/M codes, Medicare increased reimbursement for services performed in a non-facility setting.

For example (Indiana rates):

  • Code 99213
    • 2025: $83.88
    • 2026: $90.09
    • Increase: +$6.21
  • Code 99214
    • 2025: $118.14
    • 2026: $128.33
    • Increase: +$10.19
  • Code 99215
    • 2025: $166.04
    • 2026: $182.08
    • Increase: +$16.04

These increases represent meaningful revenue gains for practices with high office-based visit volume. Multiplied across hundreds or thousands of visits annually, the impact becomes significant.

For independent practices and provider-owned clinics, this shift helps offset rising operational costs — staffing, rent, technology, and compliance pressures.

Facility Services: Rates Decreased

On the flip side, reimbursement for E/M services performed in a facility setting decreased (excluding anesthesia services).

Using code 99213 again as an example (Indiana rates):

  • Code 99213 – Facility
    • 2025: $60.62
    • 2026: $55.10
    • Decrease: -$5.52

Similarly:

  • Code 99214 – Facility
    • 2025: $89.21
    • 2026: $80.95
    • Decrease: -$8.26
  • Code 99215 – Facility
    • 2025: $132.04
    • 2026: $120.15
    • Decrease: -$11.89

While these reductions may appear modest at first glance, the cumulative effect across hospital-based or facility-heavy provider groups can be substantial.

Why This Matters More Than Ever

The 2026 update reinforces a trend we’ve seen before: site of service matters… a lot.

Two providers performing the same CPT code may now see a widening reimbursement gap based solely on where the service occurs.

That affects:

  • Independent practices
  • Hospital-employed physicians
  • Specialty providers splitting time between clinic and facility
  • Groups evaluating expansion or restructuring

This isn’t just a Medicare billing detail. It’s a strategic financial variable.

Strategic Considerations for Practices

With these changes in place, now is the time to:

1. Analyze Your Site-of-Service Mix

What percentage of your services are billed as facility vs. non-facility? Even a small shift in volume could materially affect revenue projections. Are you performing services in the facility that could be performed in your office?

2. Review Employment & Compensation Models

If providers split time between hospital and clinic, compensation formulas tied to collections may shift unexpectedly.

3. Revisit Revenue Forecasting

Budget projections built on 2025 rates need to be updated. For some practices, 2026 could bring improved margins. For others, it may require expense adjustments.

4. Confirm Accurate POS Coding

With rate differences increasing, correct Place of Service (POS) coding is even more critical. Errors could now result in larger reimbursement discrepancies.

The Bottom Line

For office-based providers, 2026 Medicare updates bring welcome increases.

For providers performing services in a facility setting, reimbursement tightening continues.

The services haven’t changed, but where they’re performed now carries even more financial weight. If you have questions about how these updates affect your specific billing situation, contact your HSC Medical Billing representative or give our team a call at 812.473.0181. We’re here to help you navigate the changes with clarity and confidence.

Find the full 2026 Medicare E/M rate changes for Indiana and Kentucky here:

A Message from HSC’s New CEO

Brant Kennedy, CPA, Manufacturing Team Lead

One month into the CEO role at HSC, what stands out to me most is what has long defined this firm: our people. People who show up every day with a genuine commitment to our clients and to each other.

This past year was especially meaningful as we marked 50 years of HSC. It gave us the opportunity to reflect on the relationships and trust that continue to shape how we serve our clients and support one another.

I’m incredibly proud of our recent promotions and the continued growth we’re seeing across the firm. These advancements reflect the talent of our people and our long-standing commitment to developing leaders from within.

We’re also making thoughtful investments in technology that support how our team works and collaborates. These tools help us operate more efficiently while keeping personal relationships and high-quality service at the center of everything we do.

As we look ahead, we remain committed to operating as an independent firm. That independence allows us to make long-term decisions with our clients and our people in mind, while staying true to the values that have guided HSC for five decades.

I’m grateful to be part of a team that cares deeply about our clients, our people, and the firm — and I’m confident in what lies ahead.

Brant Kennedy, CPA

CEO

Harding, Shymanski & Company Earns Best of Accounting™ Client Satisfaction Award for Third Consecutive Year

Harding, Shymanski & Company, P.S.C. is proud to announce that the firm has earned the Best of Accounting™ Client Satisfaction Award for the third year in a row.

This national recognition, presented by ClearlyRated, is based entirely on verified client feedback. Firms receiving the award must achieve satisfaction scores significantly higher than the industry average, placing Harding, Shymanski & Company among a select group of accounting firms recognized for consistently exceptional client service.

“Receiving this award for the third consecutive year is especially meaningful because it reflects our clients’ experiences,” said Brant Kennedy, CEO. “We work hard to be proactive, responsive, and invested in our clients’ long-term success, and this recognition confirms that our approach is making a difference.”

The award reflects the firm’s continued focus on relationship-driven service, industry expertise, and proactive guidance across tax, audit, advisory, outsourcing, and specialty services.

Harding, Shymanski & Company remains committed to delivering high-quality service and trusted advice as clients navigate an increasingly complex business environment.

Learn more about our firm and services: https://hsccpa.com/services/

Meals and Entertainment Quick Reference Guide

Understanding the tax treatment of business meals, entertainment, and related expenses continues to be a challenge for many business owners. Deductibility rules have shifted over time, temporary provisions have expired, and additional changes are scheduled to take effect beginning in 2026. As a result, expenses that were once fully deductible, or partially deductible, may now be limited or disallowed altogether.

The IRS rules governing business meal deductions, entertainment expenses, employee meals, and business gifts are highly specific and documentation-driven. Misclassifying these expenses can lead to missed deductions, compliance issues, or unwanted scrutiny during an audit. This is especially important for businesses that frequently incur client meals, employee travel expenses, or host employee events.

To help businesses navigate these rules with confidence, we’ve created a Meal and Entertainment Quick Reference Guide. This resource outlines the current deductibility rules and highlights upcoming changes so business owners and financial decision-makers can plan ahead and avoid surprises at tax time.

Have additional questions? Contact our tax experts to learn more.

Tax laws and guidance continue to evolve. To stay informed about changes that may affect your business, follow us on LinkedIn and Facebook or sign up to receive our newsletter, where we regularly share timely tax updates and insights.

Honored to Receive Gold in the Community Choice Awards

We’re honored to share that our Payroll Department has been awarded Gold in this year’s Evansville Community Choice Awards!

Our payroll professionals work hard behind the scenes to support the businesses that keep our region moving. From accuracy and compliance to service and responsiveness, they take pride in doing the kind of work most people only notice when something goes wrong. So earning recognition from the community means the world to us.

To everyone who voted, THANK YOU. Your confidence inspires us to continue raising the bar and delivering payroll services that make your operations smoother and your lives easier.

We’re grateful, we’re energized, and we’re ready for another year of serving our community.

Year-End Planning Webinar Series

Webinar Series - Succession & Tranisition Planning, Estate Planning, Tax Planning, and Long-Term Care Planning.

We’re excited to invite you to our upcoming 2025 Fall Webinar Series. Each session is designed to help you plan ahead, protect your wealth, and make informed decisions for the future.

Upcoming Sessions:
Succession & Transition Planning

Tuesday, October 7, 2025

10:00 am CT / 11:00 am ET
Successfully selling or transitioning your business takes years of planning. Let’s talk about how to get started.

Estate Planning
Tuesday, October 28, 2025

2:00 pm CT / 3:00 pm ET
Even celebrities make costly estate planning mistakes – just look at Robin Williams, Whitney Houston, and Heath Ledger. Join us to unpack these real-life mistakes and learn how to avoid doing the same.

Tax Planning & Year-End Strategies
Wednesday, November 12, 2025

10:00 am CT / 11:00 am ET
Staying ahead on tax updates and year-end strategies is key to closing out strong. Let’s talk about what you need to know before the year wraps up.

Long-Term Care: Financial Impact & Planning
Wednesday, December 3, 2025

2:00 pm CT / 3:00 pm ET
Long-term care can make a big impact on your financial planning. Join us to learn more.

Each session will provide practical insights and strategies that you can apply immediately. Whether you’re preparing for transition, planning your estate, optimizing year-end tax strategies, or considering long-term care, these webinars are designed to support your financial goals.

Reserve your spot for one or all sessions. We look forward to having you join us.

Save Your Spot

Advisory Services offered through Avantax Planning Partners, Inc., a registered investment adviser. Securities may be offered through Cetera Wealth Services, LLC, member FINRA/SIPC. Additional advisory services may be offered through Cetera Investment Advisers LLC. Cetera named entities and Avantax Planning Partners, Inc. are affiliated. 3390 Asbury Rd, Dubuque, IA 52002. 563-582-2855.

Check your Financial Professionals registration status on https://brokercheck.finra.org/ and/or https://adviserinfo.sec.gov/.

Cetera named entities and Avantax Planning Partners, Inc. are independent of and unrelated to Harding.  Although Cetera named entities and Avantax Planning Partners, Inc. do not provide tax or legal advice, or supervise tax, accounting or legal services, our financial professionals may offer some or all of these services through their independent outside business. This information is not intended as tax or legal advice.

Updated: Manufacturing in Foreign Trade Zones – Explore the Savings

Benefits of manufacturing in Foreign Trade Zones

Is your business paying significant duty and excise tax on foreign imports? If you import raw materials to manufacture and sell the product in the United States or re-export the finished product, you might be able to benefit from a foreign trade zone (FTZ).

What is a Foreign Trade Zone?

The U.S. government first created foreign trade zones to attract and promote international business in 1934.  Manufacturing activity in FTZs became broadly permitted starting in 1971.  Today, there are 260+ FTZ projects and nearly 400 subzones nationwide, serving as critical hubs for manufacturers, distributors, and e-commerce companies.

The term “foreign trade zone” (FTZ) means a discrete area located in or adjacent to a port of entry that is authorized by Congress to receive preferential treatment under the customs laws of the United States. FTZs are not considered to be in the customs territory of the United States. This allows a business to import and store foreign merchandise without paying customs duties or Federal excise tax until the merchandise enters U.S. commerce.

2025 update: With the elimination of the de-minimis exemption in recent trade policy changes (which had previously allowed duty-free imports under $800), FTZs have become even more valuable, especially for e-commerce and consumer goods companies facing higher tariff exposure.

What will an FTZ do for me?

There are several benefits for a business to utilize an FTZ. A manufacturer that imports raw material into the United States is required to pay duty at the time the raw material enters the country. However, merchandise or goods brought into an FTZ are not assessed duty until the merchandise leaves the zone or enters U.S. commerce.

In addition, if the imported merchandise is brought into an FTZ and then exported back out of the country and does not enter into U.S. commerce, no duty is ever due. There are also no time limitations on how long goods can remain in an FTZ, regardless of whether the goods are subject to duty.

Why this matters now: In today’s volatile tariff environment, in which a universal 10% tariff began in April, and county-specific ‘reciprocal tariffs’ fully took effect in recent trade policy changes, companies are relying on FTZs to defer duty costs and preserve cash flow until the moment goods actually enter the U.S. market.  Note that many of the reciprocal tariffs were paused, delayed, or modified as continued negotiations take place.

U.S. Import Duty Basics

U.S. duty or import duty is a tax on goods that arrive in the United States Customs port with the intent to unload the goods and enter them into U.S. commerce. There are several different types of import duties, which are calculated in a variety of ways. The import duty depends on the type of product imported, how much is being imported, its declared value, from which country the product was exported, and several other factors. The import duty can range from zero to 100% or more of the product’s declared value.

Tip: FTZs also provide “inverted tariff” benefits — where duty rates on finished products may be lower than on raw components. In those cases, companies can choose to apply the lower finished-goods rate, which can create significant savings.

Can I Manufacture or Assemble in an FTZ?

Generally, yes. Foreign and domestic merchandise brought into an FTZ can be manipulated or manufactured in the zone unless it is prohibited by law. The business can then store, sell, exhibit, separate, repack, assemble, distribute, sort, grade, clean, mix with foreign or domestic merchandise, or manipulate the merchandise within the FTZ.

Foreign production equipment, such as machinery or parts for specific equipment to manufacture merchandise, may be brought into an FTZ. No duty shall be assessed on imported production equipment until it is completely assembled, installed, tested, and used in the production for which it was intended.

A business that manufactures in an FTZ does not pay duty on waste, scrap, and yield loss. For example, a plastic facility manufacturing polysulfone (5% duty) imports and uses the raw material polypropylene (also 5% duty). During the production process, 10% of the raw material polypropylene is scrapped and considered obsolete. If this business operates outside an FTZ, it will pay $50,000 in duty on $1,000,000 of imported polypropylene. If the business utilizes the FTZ, no duty is owed on the polypropylene when it is brought into the zone. In addition, 10% or $100,000 of the polypropylene is lost during the production cycle. Assuming all of the end product is sold in the U.S., the 5% duty totals only $45,000. This is a savings of 10% in duty.

Modern twist: Increasingly, FTZ manufacturers are using automation, blockchain tracking, and real-time customs compliance software to streamline operations and reduce compliance risks. These tools make FTZ participation easier and more efficient than in years past.

Additional Benefits of FTZs

An additional benefit of an FTZ is protection against theft. After the merchandise has been manipulated or manufactured in an FTZ, the merchandise will be taken under the supervision of the Secretary of the Treasury. As long as the tariff classification has not changed since entry or during the manufacturing process, merchandise will be taken under supervision through electronic compliance systems, audits, and site inspections within the foreign trade zone. A declared value will be determined, and the duty or excise tax on the merchandise exempted while in the FTZ.

Bottom Line

There are several benefits to utilizing an FTZ. In 2025, FTZs are increasingly considered essential tools for tariff management and supply chain resilience. Whether you’re a manufacturer, distributor, or e-commerce retailer, the use of an FTZ can increase cash flow and profitability under the right circumstances.

Have questions about how an FTZ strategy could benefit your business?
Reach out to our manufacturing industry experts. As leaders of our Manufacturing Industry Team, Brant and John can help you evaluate opportunities, model potential savings, and navigate the application process.


This article provides general information and should not be considered specific tax or legal advice. Consult qualified professionals for your specific situation.

Find more information about FTZs from the International Trade Administration and U.S. Customs and Border Protection.