Transmittals

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

User Enhancement Change Request (UECR) ViPS Medicare System (VMS) - Update Interactive Correspondence Online Reporting (ICOR) Subsystem to Add Wildcard Search Capability within Claim Control Number (CCN)

User Enhancement Change Request (UECR): ViPS Medicare System (VMS) – Improve Processing of Capped Rental Items Billed with RT (right) / LT (left) Modifiers

User Enhancement Change Request (UECR): ViPS Medicare System (VMS) - Update the Quality Assurance (QA) subsystem to Automate Setting Date Ranges on the QA Selection – Date Card Screen (VMAP/2/2)

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

New Waived Tests

Implementation of a New National Uniform Billing Committee (NUBC) Condition Code KX Documentation on file. Requirements specified in the medical policy have been met and Implementation of a New NUBC Value Code 92 Invoice Cost of Drug/Biologic. For use with Revenue Category 0636 when required by federal regulation.

Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for Myelodysplastic Syndromes (MDS) National Coverage Determination (NCD) 110.23

"National Fee Schedule for Medicare Part B Vaccine Administration CMS - January 2025 "

"Update to Rural Health Clinic (RHC) All Inclusive Rate (AIR) Payment Limit for Calendar Year (CY) 2025 "

"Update to the Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) for Calendar Year (CY) 2025 "

Update in Performance Based Adjustments (PBA) Processing for Kidney Care Choices (KCC) Model - Implementation

Updates of Chapter 4 and Exhibits in Publication (Pub.) 100-08, Including the Unified Program Integrity Contractor (UPIC) and Medical Review Accuracy Contractor (MRAC) Coordination Process.

Implementation CR - To Send Provider-Based Practice Location Types to the Fiscal Intermediary Shared System (FISS) on Provider Enrollment Chain & Ownership System (PECOS) Extract Files and for FISS to Process so Medicare Administrative Con

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