Transmittals

April 2025 Bi-Annual Update of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)

Requirements for Adjusting/Demanding and Reporting Office of the Inspector General (OIG) Identified Overpayments

The Fiscal Intermediary Shared System (FISS) Submission of Copybook Files to the Provider and Statistical Reimbursement (PS&R) System

Manual Update for Pneumococcal Vaccine for 21-Valent Conjugate Vaccine

Summary of Policies in the Calendar Year (CY) 2025 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List

April 2025 Update to the Inpatient Prospective Payment System (IPPS) For Correction to Total Pass-Through Amounts Reported on the Provider Specific File (PSF) to Include Allogeneic Stem Cell Costs

Updates to sections 20.2.2, 20.2.9, 20.2.10, 40.1, 50.2, 50.3, and 80 of Chapter 16-B of the Medicare Managed Care Manual.

Implementation of System Changes for the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury (AKI) for Calendar Year (CY) 2025.

Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year (CY) 2025

Claim Status Category Codes (CSCC) and Claim Status Codes (CSC) Update

Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2025

Calendar Year (CY)2025 Home Infusion Therapy (HIT) Payment Rates and Instructions for Retrieving the January 2025 Home Infusion Therapy (HIT) Services Payment Rates Through the CMS Mainframe Telecommunications System

Regional Medicare Swing-Bed-Rates, adds Table 36 to update the Medicare Payment Rates for routine SNF-type services by swing-bed hospitals during calendar year 2025

This transmittal introduces Chapter 49, Skilled Nursing Facility and Skilled Nursing Facility Complex Cost Report, Form CMS-2540-24, effective for cost reporting periods beginning on or after October 1, 2024

Updates of Chapter 1, Chapter 2, Chapter 3, Chapter 4 and Appendices in Publication (Pub.) 100-15, Including Auditing of Program Integrity Activities in Managed Care Plans

Implementation of the Award for the Jurisdiction J (J-J) Part A and Part B Medicare Administrative Contractor (JJ A/B MAC)

Utilization of KX Modifier Medicare Physician Fee Schedule Payment for Dental Services Inextricably Linked to Covered Medical Services

Updates to Allow Category II Codes to be Submitted on Rural Health Clinic (RHC) Claims

User Enhancement Change Request (UECR): ViPS Medicare System (VMS) - Add Testing/Production Region Identifier Field on Screens

Fiscal Intermediary Shared System (FISS) - Delete Obsolete Reason Codes - Part 5