The billing landscape in healthcare is a relentless wave of deadlines and updates. Managing them without a structured approach invites chaos. Enter the billing compliance calendar — your practice's lifeline for staying ahead of the curve. A well-maintained calendar isn't just a tool; it's a necessity for any billing team aiming to keep denials at bay. Let's break down 2025 month by month, highlighting key dates and updates your team should mark.
January: Start the Year Right
Begin the year by reviewing the latest changes to CPT and ICD-10 codes. January 1 is when new codes go live. Translation? Your billing team should have already digested any updates, but this is the time to ensure all systems reflect the changes.
Think of New Year's Day as a deadline. Ensure all staff are trained on these adjustments. Physicians often overlook minor coding nuances, so a quick review session can prevent costly errors. And remember, Medicare's deductible resets on January 1 — expect an influx of patient inquiries.
February: Audit Time
February is prime for internal audits. Audits may not be fun, but they are a way to catch issues before they spiral. By now, teams should have enough claims processed under the new codes to identify trends. Are there unanticipated denial patterns? Now's your chance to resolve them before they become systemic.
March: MACRA and MIPS Reporting
March 31 is the deadline for submitting data for the Merit-based Incentive Payment System (MIPS) under MACRA. This date should be circled in red on any billing manager’s calendar. Accurate data submission can make a significant difference in reimbursements. Start prepping early. Compile quality data, and ensure it's submitted well ahead of the deadline to avoid last-minute scrambles.
April: Payer Contract Revisions
It's "negotiation season." April is when many payer contracts are up for renewal. It’s time to review terms and ensure that your practice’s needs are being met. Pay attention to reimbursement rates and any policy changes that might impact your revenue cycle. Engaging with payers now can pay dividends (literally and figuratively) later.
May: Mid-Year Code Updates
While major code updates occur in January and October, keep an eye out for minor CPT code changes in May. These aren't as extensive, but they can still affect billing processes. Ignoring them can mean more denials — something no billing team wants.
June: Staff Education
The halfway point of the year is perfect for team training. Billing codes, regulations, and compliance requirements are constantly evolving. Allocate time for staff to attend webinars or workshops on the latest trends. Continuous education is non-negotiable for maintaining a smooth billing operation.
July: Quarterly Reviews
July marks the end of Q2, and it’s smart to perform a mid-year performance review. Analyze KPIs such as days in A/R, denial rates, and reimbursement speed. Are there areas for improvement? Consider technological upgrades or workflow changes to address bottlenecks. Arrow’s AI copilot can provide valuable insights here.
August: Prepare for ICD-10 Updates
ICD-10 updates hit in October, but August is when you want to start prepping. Technical systems need updating, staff require training, and internal processes might need tweaking. Procrastination could lead to denials — and the window for ICD-10 prep is open now. Start early.
September: Payer Policy Changes
Payers often release policy changes effective October 1. These can include fee schedule adjustments or new documentation requirements. Monitor payer portals closely — their updates can be buried in a sea of notifications. Assign someone to keep an eagle eye on these portals.
October: Major Code Overhaul
October 1 is when the ICD-10 code updates become active. It’s a reset button for the medical coding world. Ensure that all systems are updated, and staff are thoroughly briefed. A misstep here can lead to denial disasters — and months of cleanup work.
November: Compliance Checks
Pre-holiday season is ideal for compliance audits. Look at documentation practices, HIPAA adherence, and any fraud or abuse vulnerabilities. The quieter pace of November makes it a good time to ensure you’re on the right side of regulations. Better to catch issues now than face penalties later.
December: Year-End Closure and Planning
December is the wind-down month, but don't relax too much. It's time to close out the year, finalize audits, and prepare financially for the coming year. Revisit what worked well and what didn’t in 2025 — use those lessons to inform your strategy for 2026. And remember, patients are rushing to use remaining insurance benefits, so expect higher volume.
Managing a billing compliance calendar isn't about ticking boxes. It's about anticipating challenges and staying agile. Keep it dynamic. The healthcare world doesn't pause for late paperwork or missed deadlines. Stay ahead.
Related Articles
