Transmittals

The factor for CY 2021 has been added and the factor for CY 2011 has been deleted.  The factors are applied on a calendar year basis.

Implementation of the Capital Related Assets Adjustment (CRA) for the Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) Under the End Stage Renal Disease Prospective Payment System (ESRD PPS)

Remove Beneficiaries Below 18 Years Old From Model Adjustments - Correction for CR 11390

Federally Qualified Health Center (FQHC) Participation in and Payment Under the Maryland Primary Care Program (MDPCP) - Implementation Change Request (CR) to correct Business Requirement (BR) 12326.7.2.

Update of Chapter 3 in Publication (Pub.) 100-08, Including Update to Medicare 2022-07-28 Program Integrity Contractor Post-Payment Review Process, and Update of Chapter 8 Pub. 100-08, Including Revision to When Contractor Suspects Additional Improper Claims

Masking the Medicare Beneficiary Identifier (MBI) on the Medicare Summary Notice (MSN)

Monthly Report of Performance Payment Adjustment (PPA) Claims - Addition to Change Request (CR) 12404 - Implementation CR

Multi-Carrier System (MCS) Removal of the Physician Pay for Reporting (P4R), Physician Quality Reporting System (PQRS) and Electronic Prescribing (ERx) Incentive Payments Financial Logic from the Claims Processing System

Modification of Existing Common Working File (CWF) Editing for Preventive Services

Corrections to Processing of Canceled Home Health Notices of Admission and of Period Sequence Edits

October 2022 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files

Claim Status Category and Claim Status Codes Update

Notice of New Interest Rate for Medicare Overpayments and Underpayments -4th Qtr Notification for FY 2022

Interns and Residents Information System (IRIS) XML Format

Instructions to the Fiscal Intermediary Shared System [FISS] Edit to Expand the Existing MA Bypass Reusable Solution PARMCC78 and Modify the Existing Logic to Read the New PARMs

New Edit for Prospective Payment System (PPS) Outpatient and Inpatient Bill Types Receiving an Outlier Payment When a Device Credit is Reported

ESRD Treatment Choices (ETC) Model Performance Payment Adjustment (PPA) - Facility Component (Implementation CR)

Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) - October 2022

July 2022 Update of the Ambulatory Surgical Center (ASC) Payment System

Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) CORE