Transmittals

Combined Common Edits Enhancements Modules CCEM Code Set Update

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

Phase 4 Implementation to Expand Monetary Amount Fields Related to Billing and Payment to Accommodate 10 Digits in Length $99,999,999.99

Phase 4 Implementation to Expand Monetary Amount Fields Related to Billing and Payment to Accommodate 10 Digits in Length $99,999,999.99

Making Care Primary (MCP) Informational Unsolicited Responses (IURs)

Quarterly Update to Home Health (HH) Grouper

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

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

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