Transmittals

Implementation of the Award for the Jurisdiction A Durable Medical Equipment Medicare Administrative Contractor (JA DME MAC)

Annual Updates to the Prior Authorization/Pre-Claim Review Federal Holiday Schedule Tables for Generating Reports

Accountable Care Organization (ACO) Primary Care Flex Model (ACO PC Flex Model)

This transmittal updates Chapter 42, Independent Renal Dialysis Facility Cost Report, Form CMS-265-11, by revising the existing instructions and electronic cost report (ECR) specifications.

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - July 2025 Update

Quarterly Update to Home Health (HH) Grouper

New Waived Tests

Update to Several Sections of the Internet-Only Manual (IOM) Publication (Pub.) 100-04, Medicare Claims Processing Manual, Chapter 23 - Fee Schedule Administration and Coding Requirements

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

Update to Publication 100-04 Medicare Claims Processing Manual Chapter 21 Medicare Summary Notices (MSN) English Exhibits for Envelope Changes Described in Previously Issued Change Request

Changes to The Electronic Correspondence Referral System (ECRS) Web to Remove the Medigap Supplemental Type ‘M’ (Medigap) as a Valid Option from Batch Submissions

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 Full-Year Continuing Appropriations and Extensions Act, 2025.

The Fiscal Intermediary Shared System (FISS) Submission of Copybook Files to the Provider and Statistical Reimbursement (PS&R) System

National Coverage Determination (NCD) 210.15 - Pre-Exposure Prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV) Prevention

National Coverage Determination (NCD) 210.15 - Pre-Exposure Prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV) Prevention

Fiscal Intermediary Shared System (FISS) User Enhancement Change Request (UECR) - Allow Override for Reason Code 37221.

Fiscal Intermediary Shared System (FISS) User Enhancement Change Request (UECR) - Allow Override for Reason Code 31407.

User Enhancement Change Request (UECR): Update Multi-Carrier System (MCS) Correspondence Entry (CE) Screens and MCS Desktop Tool (MCSDT) to Include Edit, Audit, Common Working File (CWF) - (EAC) Error Code Search Field.

Fiscal Intermediary Shared System (FISS) User Enhancement Change Request (UECR) - Modify the Healthcare Common Procedure Code (HCPC) Type of Bill (TOB) Table, MAP1I51, to Allow Automation to Update Date Fields

The Medicare Secondary Payer (MSP) Systems Contractor (MSPSC) and Common Working File (CWF) to Delete or Close Pre-Section 111 Non-Ongoing Responsibility for Medicals (ORM) Non-Group Health Plan (NGHP) MSP Records and to Purge all MSP Records that Contain an ‘N’ Validity Indicator.