Regulatory Information Center Updates: December 9, 2025


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.

CMS Center/Transmittals

Document #

Implementation of Editing for Programs of All-Inclusive Care for the Elderly (PACE) Inpatient Claims Submitted for Indirect Medical Education (IME) Payment

R13444OTN

Editing for Duplicate Processing for Practitioner Professional Services and Critical Access Hospital (CAH) Professional Services
R13515OTN
Manual Updates Adding Language to the Timing and Content of Certification and Revocation and Discharge Guidance
R13503BP
Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year (CY) 2026
R13504GI
Calendar Year (CY) 2026 Update to Rural Health Clinic (RHC) All Inclusive Rate (AIR) Payment Limit for CY 2026 and Payment Rates for Intensive Outpatient Program (IOP) Services for RHCs
R13505CP
Calendar Year (CY) 2026 Update to the Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) and Payment Rates for Intensive Outpatient Program (IOP) Services for FQHCs
R13506BP
National Correct Coding Initiative (NCCI) New/Updated Add-On Code (AOC) Edit File Format and Creation of an AOC File Retrieval Process in the Multi-Carrier System (MCS) – Implementation
R13502OTN
Summary of Policies in the Calendar Year (CY) 2026 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, Computed Tomograph (CT) Modifier Reduction List, and Preventive Services List
R13507CP
Combined Common Edits/Enhancements Modules (CCEM) Code Set Update
R13419CP
Combined Common Edits/Enhancements Modules (CCEM) Code Set Update
R13509CP
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.
R13481CP
Update to Claims Processing Instructions for National Coverage Determination (NCD) 20.4 Implantable Cardiac Defibrillators (ICDs)
R13483CP
April 2026 Healthcare Common Procedure Coding System (HCPCS) Quarterly Update Reminder R13489CP
Edit to Prevent Overpayment of Long-term Stay in Hospice
R13447OTN
Implementation of the Award for the Jurisdiction F (J-F) Part A and Part B Medicare Administrative Contractor (JF A/B MAC)
R13447OTN
Reporting of All Recovery Auditor-Initiated Claim Adjustments and their Subsequent Adjustments for Periodic Interim Payment (PIP) Facilities
R13493OTN
Calendar Year (CY) 2026 Home Infusion Therapy (HIT) Services Payment Rates and Instructions for Retrieving the January 2026 Home Infusion Therapy (HIT) Services Payment Rates Through the CMS Mainframe Telecommunications System
R13512CP
Calendar Year (CY) 2026 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment
R13514CP
Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update
R13482CP
April 2026 Bi-Annual Update of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)
R13490CP
International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)-April 2026
R13455OTN
OIG HHS/Reports Document #

Florida Retina Institute Generally Met Medicare Requirements for Ophthalmology Services Provided on the Same Day as Eye Injections

A-04-22-04086

Medicare Improperly Paid Selected Optometrists for Services Provided to Enrollees at Nursing Facilities A-05-24-00009
Podiatrists’ Claims for Evaluation and Management Services Did Not Comply With Medicare Requirements A-09-22-03012
New Jersey Did Not Ensure Providers Complied With Federal and State Requirements at All 20 Adult Day Health Services Facilities Audited A-02-24-01009
Podiatrists’ Claims for Routine Foot Care Services Did Not Comply With Medicare Requirements A-09-22-03011
Federal Register Proposed Rule Document #
Medicare and Medicaid Programs; Repeal of Minimum Staffing Standards for Long-Term Care Facilities 2025-21792
Federal Register/Notice Document #
Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2026
2025-21877
Medicare Program; Medicare Appeals; Adjustment to the Amount in Controversy Threshold Amounts for Calendar Year 2026 2025-21879
Agency Information Collection Activities: Proposed Collection; Comment Request 2025-21978
Agency Information Collection Activities: Submission for OMB Review; Comment Request 2025-22184
Medicaid and Children's Health Insurance Program (CHIP) Generic Information Collection Activities: Proposed Collection; Comment Request 2025-22187
Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area 2025-22188
Agency Information Collection Activities: Proposed Collection; Comment Request 2025-22203
Medicare and Medicaid Programs: Approval of Application by DNV Healthcare, Inc. for Initial CMS Approval of Its Ambulatory Surgical Center (ASC) Accreditation Program 2025-22219
Medicare and Medicaid Programs; Continued Approval of the American Association for Accreditation of Ambulatory Surgery Facilities' Rural Health Clinic Accreditation Program 2025-22219