Transmittals

April 2025 Integrated Outpatient Code Editor (I/OCE) Specifications Version 26.1

January 2025 Integrated Outpatient Code Editor (I/OCE) Specifications Version 26.0

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

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

New Edit Implementation for Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) for Point of Origin (PoO) Admission or Visit Code “D” Related to the Emergency Department (ED) Adjustment Policy

Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process

Update to the List of Advanced Life Support, Level 2 (ALS2) Procedures in Chapter 10, Ambulance Services, Section 30.1.1, Definition of Ground Ambulance Services

Internet Only Manual (IOM) Update, Publication (Pub.) 100-01, Chapter 7, 40.2 - General Information, Eligibility, and Entitlement Manual Chapter 7 - Contract Administrative Requirements

July 2025 Quarterly Update to Healthcare Common Procedure Coding System (HCPCS) Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement

Update End Stage Renal Disease (ESRD) Treatment Choices (ETC) Model Change Requests (CRs) to Exclude Acute Kidney Injury (AKI)

Create a New Adjustment Reason Code for Adjustments Created When the Provider Didn't Respond to an Additional Documentation Request (ADR)

End Stage Renal Disease (ESRD) Treatment Choices (ETC) Model Demo Priorities - Additional Updates

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

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

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

The Recovery and Adjustment of Medicare Claims where the Department of Veteran Affairs (VA) also Made Payment Using the Medicare Duplicate Payment (DP) Process

Instructions for Retrieving the January 2025 Opioid Treatment Program (OTP) Payment Rates Through the CMS Mainframe Telecommunications System

Removal of Gender References from CMS Publication (Pub.) 100-08, Chapter 10

April 2025 Integrated Outpatient Code Editor (I/OCE) Specifications Version 26.1

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