Transmittals

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.

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

User Enhancement Change Request (UECR): ViPS Medicare System (VMS) - Update No Related Logic to Set Using FROM Date of Service (DOS)

This transmittal updates Chapter 49, Skilled Nursing Facility and Skilled Nursing Facility Healthcare Complex Cost Report, Form CMS-2540-24, revising the existing instructions, worksheets, and electronic cost report (ECR) specifications.

Updates to Medicare Benefit Policy Manual and Medicare Claims Processing Manual for Opioid Treatment Programs (OTPs)

Updates to Medicare Benefit Policy Manual and Medicare Claims Processing Manual for Opioid Treatment Programs (OTPs)

Allow Payment for Healthcare Common Procedure Coding System (HCPCS) Code G2211 when Certain Part B Preventive Services are Provided on the Same Day

Rejections in the Medicare Adjudication Portal (MAP)

Hospice Claims Billed by Terminated Hospices

100-06 Internet Only Manual (IOM) Updates - Chapter 3 - Beneficiary Liability

Update to the All-Inclusive Rate (AIR) Add-On Payment for High-Cost Drugs Provided by Indian Health Service (IHS) and Tribal Hospitals

Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services Subject to Reasonable Charge Payment