These updates are now available on Codify. You can access them by selecting Publications/Regulatory Information from the top menu or by clicking the links below.
| Document # | |
|---|---|
|
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2026 Update |
R13648CP |
| Combined Common Edits/Enhancements Modules (CCEM) Code Set Update | R13646CP |
| Updating Consistency Editing Logic for Provider-Based Department (PBD) Claims Processing | R13644OTN |
| File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions | R13587CP |
| Annual Instructions for Downloading the Medicare ZIP Code Files for the Remainder of Calendar Year 2026 | R13597CP |
| Prior Authorization Data - Add Medicare Beneficiary Identifier (MBI) | R13645OTN |
| Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services Subject to Reasonable Charge Payment | R13639CP |
| Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits | R13619CP |
| National Fee Schedule for Vaccine Administration Quarterly Update - April 2026 | R13636CP |
| Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) – April 2026 | R13620CP |
| Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Medicare Benefit Policy Manual Chapter 13 Update for Calendar Year (CY) 2026 | R13600BP |
| Calendar Year (CY) 2026 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory (MEDPARD) Procedures | R13650CP |
| Billing Code Clarification for National Coverage Determination (NCD) 210.13 Screening for Hepatitis C Virus (HCV) in Adults | R13633OTN |
| Implementation of Wasteful and Inappropriate Service Reduction (WISeR) Model Prior Authorization and Medical Review Process and Establishment of New Quarterly Change Request (CR) Process for Possible Future Changes to Information Included in Attachments A, B, C, D, E, and F. | R13652DEMO |
| OIG HHS/Reports | Document # |
|---|---|
|
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2025 |
OEI-03-26-00040 |
| New York Should Improve Its Monitoring of Low-Income Home Energy Assistance Program Subrecipients | A-02-23-02005 |
| Medicare Home Health Agency Provider Compliance Audit: Alternate Solutions Homecare of Dayton | A-05-24-00014 |
| Fourteen of Thirty Selected Indian Health Service and Rural Providers Did Not Comply or May Not Have Complied With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments | A-09-23-01001 |
| Office of Inspector General’s Partnership With the Office of the Utah Inspector General: Inspector General’s Report Audit of Capitation Payments Made Concurrently With Another State | A-07-23-05136 |
| Federal Register/Notice | Document # |
|---|---|
| Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area (High Point Regional Health) | 2026-03110 |
| Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area (WRMC Hospital Operating Corporation) | 2026-03111 |
| Agency Information Collection Activities: Submission for OMB Review; Comment Request | 2026-03118 |
| Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area (Alleghany County Memorial Hospital, Inc.) | 2026-03119 |
| Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area (Lexington Medical Center) | 2026-03277 |
| Medicare and Medicaid Programs; Announcement of Application From a Hospital Requesting Waiver for Organ Procurement Service Area (Hugh Chatham Memorial Hospital, Inc.) | 2026-03278 |
| Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-October Through December 2025 | 2026-03437 |
| Agency Information Collection Activities: Submission for OMB Review; Comment Request | 2026-03542 |
| CMS Forms | Document # |
|---|---|
| REHAB UNIT CRITERIA WORKSHEET | cms437a |
| Federal Register-Rule | Document # |
|---|---|
| Medicare Program; Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating; Hospital Price Transparency; and Notice of Closure of a Teaching Hospital and Opportunity To Apply for Available Slots; Correction | 2026-03578 |
| Medicare Claim Processing Manual | Document # |
|---|---|
| Chapter 12 - Physicians/Nonphysician Practitioners | clm104c12 |
| Chapter 32 – Billing Requirements for Special Services | clm104c32 |