Transmittals

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

Implementation of Changes in the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Payment for Dialysis Furnished for Acute Kidney Injury (AKI) in ESRD Facilities for Calendar Year (CY) 2025

National Coverage Determination (NCD) 20.36 Implantable Pulmonary Artery Pressure Sensors for Heart Failure Management

National Coverage Determination (NCD) 20.36 Implantable Pulmonary Artery Pressure Sensors for Heart Failure Management

Technical Revisions Only to the Claims Processing Manual (CPM), Publication (Pub) 100-04, Chapter 18 and Chapter 32

Updates to the Internet Only Manual, Publication 100-06, Chapter 3, Overpayments, Sections 120 and 130

Implementation of the Award for the Jurisdiction A Durable Medical Equipment Medicare Administrative Contractor (JA DME MAC)

Annual Updates to the Prior Authorization/Pre-Claim Review Federal Holiday Schedule Tables for Generating Reports

Accountable Care Organization (ACO) Primary Care Flex Model (ACO PC Flex Model)

This transmittal updates Chapter 42, Independent Renal Dialysis Facility Cost Report, Form CMS-265-11, by revising the existing instructions and electronic cost report (ECR) specifications.

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

Quarterly Update to Home Health (HH) Grouper

New Waived Tests

Update to Several Sections of the Internet-Only Manual (IOM) Publication (Pub.) 100-04, Medicare Claims Processing Manual, Chapter 23 - Fee Schedule Administration and Coding Requirements

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