These updates are now available on Codify by AAPC. You can access them by selecting Publications/Regulatory Information from the top menu or by clicking the links below.
| Document # | |
|---|---|
|
Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 32.0, Effective January 1, 2026. |
R13410CP |
| Changes to the Laboratory National Coverage Determination (NCD) Edit Software for 01-01-2026 | R13404CP |
| 2026 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments | R13471CP |
| The purpose of this Change Request (CR) is to update Publication 100-04, Medicare Claims Processing Manual, Chapter 9, 18, and Publication 100-02, Medicare Benefit Policy Manual, Chapter 13, to align with the current policy. | R13547BP |
| Revisions to Publication 100-04, Medicare Claims Processing Manual, Chapters 9, 18, and Publication 100-02, Medicare Benefit Policy Manual, Chapter 13 To Include Updated Information | R13547CP |
| Update to the Internet Only Manual (IOM) Publication 100-04, Chapter 18, Sections 150.1, 150.2.1, 150.3 and Chapter 32, Sections 12.1, 12.3, 320.3.3, 400.2.2, 400.2.3 and 400.2.3.1 for Coding Revisions to National Coverage Determination (NCDs) - October 2025 Change Request (CR) 14041 | R13549CP |
| Updates to the Internet Only Manual (IOM) Publication 100-04, Chapter 32, Sections 69.1, 69.6 and 69.9 to Clarify Requirements for Clinical Trial Services | R13551CP |
| National Fee Schedule for Vaccine Administration Quarterly Update - January 2026 | R13553CP |
| January 2026 Annual Rural Emergency Hospital (REH) Monthly Facility Payment Amount\ | R13556CP |
| Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 32.1, Effective April 1, 2026 | R13545CP |
| Cardiac Contractility Modulation (CCM) for Heart Failure (HF) | R13538CP |
| Cardiac Contractility Modulation (CCM) for Heart Failure (HF) | R13538NCD |
| Calendar Year 2026 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule | R13519CP |
| April 2026 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files | R13532CP |
| January 2026 Annual Rural Emergency Hospital (REH) Monthly Facility Payment Amount | R13536CP |
| Editing for Hospital Services Provided to Hospice Enrollees | R13560OTN |
| OIG HHS/Reports | Document # |
|---|---|
|
Oklahoma Medicaid Fraud Control Unit: 2025 Inspection |
OEI-07-25-00060 |
| Medicare Advantage Compliance Audit of Specific Diagnosis Codes Humana Health Benefit of Louisiana (Contract H1951) Submitted to CMS | A-06-21-02001 |
| Excluding Noncovered Versions Would Have Substantially Lowered Fourth-Quarter 2025 Part B Payment Amounts for Stelara Biosimilars | OEI-BL-25-00240 |
| Medicare Home Health Agency Provider Compliance Audit: Guardian Home Care, LLC | A-07-24-05146 |
| Trends in Dual-Eligible Enrollees’ Access to Drugs Under Part D, 2011-2025 | OEI-05-25-00350 |
| Some Selected Health Centers Received Duplicate Reimbursement From HRSA For COVID-19 Testing Services | A-02-23-02009 |
| Nine of Thirty Selected Assisted Living Facilities Did Not Comply With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments | A-02-23-01012 |
| Illinois Made Unallowable Managed Care Capitation Payments on Behalf of Incarcerated Medicaid Enrollees | A-05-24-00019 |
| Federal Register Proposed Rule | Document # |
|---|---|
| Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children | 2025-23464 |
| Medicare and Medicaid Programs; Hospital Condition of Participation: Prohibiting Sex-Rejecting Procedures for Children | 2025-23465 |
| Global Benchmark for Efficient Drug Pricing (GLOBE) Model | 2025-23702 |
| Guarding U.S. Medicare Against Rising Drug Costs (GUARD) Model | 2025-23705 |
| Federal Register/Notice | Document # |
|---|---|
| Agency Information Collection Activities: Submission for OMB Review; Comment Request | 2025-23116 |
| Announcement of the Approval of COLA as an Accreditation Organization for the Specialties of Clinical Cytogenetics and Radiobioassay Under the Clinical Laboratory Improvement Amendments of 1988 | 2025-23434 |
| Agency Information Collection Activities: Submission for OMB Review; Comment Request | 2025-23506 |
| Agency Information Collection Activities: Proposed Collection; Comment Request | 2025-23507 |
| Agency Information Collection Activities: Proposed Collection; Comment Request | 2025-23582 |
| Statement of Organization, Functions, and Delegations of Authority | 2025-23588 |
| Federal Register/Rule | Document # |
|---|---|
| Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2026 and Updates to the IRF Quality Reporting Program; Correction | 2025-23081 |