Transmittals

Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Medicare Benefit Policy Manual Chapter 13 Update

Transmittal 13052 issued January 16, 2025, is being rescinded and replaced by Transmittal 13128, dated March 14, 2025, to update business requirement 13787.2. All other information remains the same. Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services Subject to Reasonable Charge Payment

Transmittal 13052 issued January 16, 2025, is being rescinded and replaced by Transmittal 13128, dated March 14, 2025, to update business requirement 13787.2. All other information remains the same. User Enhancement Change Request (UECR): ViPS Medicare System (VMS) - Create Error Message in the Beneficiary Information Tracking System (BITS) to Limit the Prior Authorization (PA) Healthcare Common Procedure Coding System (HCPCS) within a Unique Tracking Number (UTN)

Enhancing Compliance and Payment Accuracy for Physician Services in Skilled Nursing Facilities

Sixteenth General Update to Provider Enrollment Instructions in Chapter 10 of CMS Publication 100-08

July 2025 Healthcare Common Procedure Coding System (HCPCS) Quarterly Update Reminder

Indian Health Services (IHS) Hospital Payment Rates for Calendar Year 2025

The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year (FY) 2023 for Inpatient Prospective Payment System (IPPS) Hospitals, Inpatient Rehabilitation Facilities (IRFs), and Long Term Care Hospitals (LTCHs)

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

Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits

Update to Provider Enrollment Appeals and Rebuttals Processing Instructions and Model Letters

Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04 Chapter 3, Inpatient Hospital Billing, Section 20.2.1

Rejections in the Medicare Adjudication Portal (MAP)

Phase 5: Implementation to Expand Monetary Amount Fields Related to Billing and Payment to Accommodate 10-Digits in Length ($99,999,999.99)

Principal Diagnosis Code Reporting Update for Hospice and Manual Updates to Sections 30.3, 40.2, and 50 of Chapter 11 of the Claims Processing Manual: Processing Hospice Claims

Updates to the Internet Only Manual (IOM) Publication100-06 Chapters 3 Overpayments and 4 Debt Collection

Fiscal Intermediary Shared System (FISS) User Enhancement Change Request (UECR) - Create a New Additional Development Request (ADR) Location Prior Authorization (PA) Claims

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

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

Manual Updates Regarding Home Health Adjustments and Skilled Nursing Facility, Home Health and Hospice Pricer Information