Transmittals

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

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

Incorporation of Recent Provider Enrollment Regulatory Changes into Chapter 10 of CMS Publication (Pub.) 100-08 - Calendar Year (CY) 2026 Home Health Prospective Payment System (HH PPS) Final Rule

Quarterly Update to Home Health (HH) Grouper

Quarterly Update of Healthcare Common Procedure Coding System (HCPCS) Codes Used for Home Health Consolidated Billing Enforcement

Fiscal Year (FY) 2027 Annual Update to the Medicare Code Editor (MCE) and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and Procedure Coding System (ICD-10-PCS)

Section 2231, Regional Medicare Swing-Bed-Rates, updates Table 38 to correct the Medicare Payment Rates for routine SNF-type services by swing-bed hospitals during calendar year 2027. These rates should be used to carve out swing-bed costs on the hospital cost report.

This transmittal updates Chapter 40, Hospital and Hospital Health Care Complex Cost Report (Form CMS-2552-10), by clarifying and revising the existing instructions and by revising existing edits. Effective dates vary.