Transmittals

Extending the Default Recoupment Date for Part A Cost Report Overpayments and Revision of the Medicaid Check Criterion for Debts Submitted for Close-Out

International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)- January 2027

International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)- January 2027 2 of 2

Revised Appendix B, Interpretive Guidelines for Home Health Agencies: New Acceptance-to-Service requirements for home health agencies at 42 CFR 484.105(i).

Update to Pub. 100-02 Medicare Benefit Policy Manual, Chapter 15, Section 110.8 Durable Medical Equipment Prosthetics Orthotics and Supplies (DMEPOS) Benefit Category Determinations

Adjusted Hourly Salary Equivalency Amount Monthly Inflation Factors For Critical Access Hospitals (CAH) and CAHs With Swing Beds, provides inflation factors to be applied to the published April 10, 1998, physical therapy, respiratory therapy, occupational and speech-language pathology, guideline amounts at the start of a provider’s cost reporting period and remain in effect for the entire cost reporting period.

Provides for calendar year (CY) inflation factors to update previous years’ reasonable compensation ranges. The factor is from the cost category Professional Fees: Labor Related in the CMS Prospective Payment System Hospital Input Price Index. The data in the Input Price Index is taken from actual data for the most recent year from the Employment Cost Index (ECI) for Professional and Related Services published by the Bureau of Labor Statistics.

Update to the Internet Only Manual (IOM) Publication (Pub.) 100-06 Chapter 8, Contractor Procedures for Provider Audits

Revisions to Chapter 12 (The Comprehensive Error Rate Testing (CERT) Program) and Exhibit 46 in the Exhibits Chapter of Publication (Pub.) 100-08 (Medicare Program Integrity Manual)

Send 'Reason for Denial' Value in Prior Authorization Data to the Integrated Data Repository (IDR)

Updates to Chapters 4 and Exhibit 16 in Publication (Pub.) 100-08, Including Updates to the Provider Identity Theft Investigations, and Victimized Provider Waiver of Liability Process

Modify the Application Logic to Conditionally Retain the Medicare Carrier System (MCS) Medicare Secondary Payer (MSP) Claim Trailer Based on Specific Common Working File (CWF) Error Codes, Dispositions, and Override Values

Influenza Vaccine Payment Allowances - Annual Update for 2026-2027 Season

Expansion of the Supplemental Security Income (SSI) Ratio on the Inpatient Provider Specific File (PSF)

Implementation of VMS Application Programming Interfaces (APIs) to Support the Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) Migration to the Centers for Medicare & Medicaid Services (CMS) Amazon Web Services (AWS) Contact Center Platform

Notice of New Interest Rate for Medicare Overpayments and Underpayments -4th Quarter Notification for FY 2026

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

Health Insurance Portability and Accountability Act (HIPAA) Electronic Data Interchange (EDI) Front End Updates for October 2026

ECRS Update for Prescription Drug Inquiries (PDIs) to Prevent the Creation of Records with Invalid or Missing Information and to Reduce the Number of Records with Invalid Insurer Names

Reporting Face-to-Face Encounter Conducted by a Hospice Physician or Hospice Nurse Practitioner for Recertification via Telecommunications Technology on Hospice Claims, effective January 1, 2027