Transmittals

April 2026 Update to the Medicare Severity – Diagnosis Related Group (MS-DRG) Grouper and Medicare Code Editor (MCE) Version 43.1

Extensions of Certain Temporary Changes to the Low-Volume Hospital Payment Adjustment and the Medicare-Dependent Hospital (MDH) Program under the Inpatient Prospective Payment System (IPPS) Provided by the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026

Chapter 3 Sections 170-190 - General Overpayment Provisions - Update of Citations and Terminology Used

Updates to Internet Only Manual, Publication 100-06, Chapter 4, Section 70.16 (Debt Close-Out)

Implementation of Wasteful and Inappropriate Service Reduction (WISeR) Model Prior Authorization and Medical Review Process and Establishment of New Quarterly Change Request (CR) Process for Possible Future Changes to Information Included in Attachments A, B, C, D, E, and F.

File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions

Updates of Chapter 4 in Publication (Pub.) 100-08, Including Updates to the Recovery Audit Contractor Data Warehouse (RACDW) Process

Updates of Chapters 1-5 in Publication (Pub.) 100-15, Including Updates to the Guidance Terminology, Existing Definitions, and Details to Standing Guidance

Implementation CR - Send Transplant Program Hospital Type and the New Organ Types to the Fiscal Intermediary Shared System (FISS) on Provider Enrollment Chain & Ownership System (PECOS) Extract Files and for FISS to Process so PECOS is the system of Record for the Transplant Program Hospital Type and for the Organs Type Transplanted at the Hospital

Update to the Internet Only Manual (IOM) for Inpatient Billing of Chimeric Antigen Receptor (CAR) T-Cell Therapy in Publication (Pub.) 100-04; Chapter 32 Billing Requirements for Special Services, Section 400.3 Payment Requirements

Editing for Hospital Services Provided to Hospice Enrollees

January 2026 Annual Rural Emergency Hospital (REH) Monthly Facility Payment Amount

April 2026 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files

Calendar Year 2026 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule

Cardiac Contractility Modulation (CCM) for Heart Failure (HF)

Cardiac Contractility Modulation (CCM) for Heart Failure (HF)

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 32.1, Effective April 1, 2026

January 2026 Annual Rural Emergency Hospital (REH) Monthly Facility Payment Amount\

National Fee Schedule for Vaccine Administration Quarterly Update - January 2026

Updates to the Internet Only Manual (IOM) Publication 100-04, Chapter 32, Sections 69.1, 69.6 and 69.9 to Clarify Requirements for Clinical Trial Services