Medical Billing Services NAICS 541219

Mar 3, 2026 - CMS Announces Pause On New Durable Medical Equipment Suppliers

• The Centers for Medicare and Medicaid Services announced in late February a nationwide moratorium on new suppliers of medical equipment such as gauze, oxygen tanks, urinary catheters, and breast prostheses for postmastectomy patients. Medical equipment suppliers frequently use specialized medical billing firms to manage complex, high-error-rate insurance claims. The Trump administration cited a need to address “fraud, waste, and abuse” in the industry. The decision to enact a moratorium came after an analysis of current and historic Medicare enrollment and claims data, according to a Federal Register notice. The affected companies, suppliers who provide durable medical equipment, prosthetics, orthotics, and supplies, make up a very small portion of the agency’s $1.7 trillion budget, but the industry has recurring issues with fraud, according to the notice. Federal investigations have found that Medicare improperly paid $34 million between 2015 and 2017, and $22.7 million between 2018 and 2024 to suppliers.
• Single-specialty medical groups averaged an 8% first-submission claim denial rate, according to the Medical Group Management Association's 2023 DataDive. Mitigation efforts have paid off for some practices, however. Practices experiencing reduced claim denials credited enhanced staff training for front desk workers and establishing a denials task force team dedicated to improving clinical documentation, eligibility verification, and authorizations. These practices also noted either hiring additional coding and billing staff or having their coders pursue new training and/or certifications as strong denial mitigators.

• The patient payment rate to hospitals decreased after the coronavirus pandemic, according to a study published in JAMA Health Forum. The mean repayment rate was approximately 54% from January 2018 through February 2020 for both privately insured and Medicare Advantage patients. The rate then started decreasing among both groups, the study found. The mean repayment rate for privately insured patients in 2023 was about 14.3% lower than in 2021. For those with Medicare Advantage, the rate decreased by almost 17%. Patients were also less likely to pay their hospital bills when they were higher. The repayment rate among the privately insured for bills over $1,000, for example, was generally under 35% versus about 50% for bills of about $100. Medicare Advantage enrollees tended to do the same, although the repayment rate was even lower for larger hospital bills.
• Medical billing services industry employment increased slightly and average wages for nonsupervisory employees decreased slightly during the first month of 2026, according to the US Bureau of Labor Statistics (BLS). Medical billing services industry sales are forecast to decrease at a 0.15% compounded annual rate from 2025 to 2029, slower than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.