Transmittals

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 31.3, Effective October 1, 2025.

Updates to No Legal Obligation to Pay for or Provide Services and Examples of Application of Government Entity Exclusion (Pub. 100-02, chapter 16, sections 40 and 50.3.3 and newly created section 40.7) and Claims Submitted for Items or Services Furnished to Medicare Beneficiaries in State or Local Custody Under a Penal Authority (Pub. 100-04, chapter 1, section 10.4)

Updates to No Legal Obligation to Pay for or Provide Services and Examples of Application of Government Entity Exclusion (Pub. 100-02, chapter 16, sections 40 and 50.3.3 and newly created section 40.7) and Claims Submitted for Items or Services Furnished to Medicare Beneficiaries in State or Local Custody Under a Penal Authority (Pub. 100-04, chapter 1, section 10.4)

July Quarterly Update for 2025 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule

Instructions for Downloading the Medicare ZIP Code File for October 2025 Files

Updates to Medicare Claims Processing Manual for Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC) Chapter 9

Updates to the Medicare Carrier System (MCS), the Viable Information Processing Systems Medicare Systems (VMS) and the Common Working File (CWF) Processes to Capture and Further Automate the Medicare Secondary Payer (MSP) Processes

Quarterly Update to the End Stage Renal Disease Prospective Payment System (ESRD PPS)

Screening for Hepatitis C Virus (HCV) Health Insurance Portability and Accountability Act (HIPAA) Eligibility Transaction System (HETS) Coding Updates (Part 2 HETS Business Requirements for CR 14041)

October 2025 (2026 File) Update of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)

July 2025 Update of the Ambulatory Surgical Center [ASC] Payment System

July Quarterly Update for 2025 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule

Internet-Only Manual (IOM) Update: Addition of Section 70.2 to Publication 100-04, Chapter 17 –Billing Zero Charges for Drug Line Items Provided at No Cost2

Combined Common Edits/Enhancements Modules (CCEM) Code Set Update

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

International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) - October 2025

Modifying Editing for Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC) Hospice Physician Services When the Beneficiary has Medicare Advantage

Omnibus Change Request (CR) Covering Updates for the Medicare Physician Fee Schedule (MPFS) Rule 2025: (1) Updates to Colorectal Cancer Screening and Hepatitis B Vaccine Policies

Omnibus Change Request (CR) Covering Updates for the Medicare Physician Fee Schedule (MPFS) Rule 2025: (1) Updates to Colorectal Cancer Screening and Hepatitis B Vaccine Policies

October 2025 Healthcare Common Procedure Coding System (HCPCS) Quarterly Update Reminder