Hospital Outpatient PPS Transmittals
The list below shows the transmittals that are directed to the Hospital Outpatient provider community, but the list may not include all instructions for which Hospital Outpatient providers are responsible. For a list of all instructions, view the Transmittals web page under Regulations and Guidance.
| CR # | Release Date | Subject | MLN Article # |
|---|---|---|---|
| 5437 | 12/15/2006 | January 2007 Non-Outpatient Prospective Payment System (NonPPS) Outpatient Code Editor Specifications Version 22.1 | MM5437 |
| 5419 | 12/22/2006 | Provider Migration | N/A |
| 5438 | 12/22/2006 | January 2007 Update of the Hospital Outpatient Prospective Payment System: Summary of Payment | MM5438 |
| 5428 | 12/22/2006 | Medicare Payment for Preadministration Related Services Associated with IVIG Administration | MM5428 |
| 5389 | 01/11/2007 | Skilled Nursing Facility (SNF) Consolidated Billing (CB) Common Working File (CWF) Edit Bypass Instructons for Hospital Emergency Room Services Spanning Multiple Service Dates | N/A |
| 5425 | 01/12/2007 | January 2007 Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE) Specifications Version 8.0 | N/A |
| 5387 | 01/19/2007 | Colorectal Cancer Screening Flexible Sigmoidoscopy and Colonoscopy Coinsurance Payment Change | N/A |
| 7252 | 12/17/2010 | January 2011 Integrated Outpatient Code Editor (I/OCE) Specifications Version 12.0 | N/A |
| 5762 | 10/26/2007 | Maintenance and Update of the Temporary Hook Created to Hold OPPS Claims that Include Certain Drug HCPCS Codes | N/A |
| 6857 | 02/26/2010 | April 2010 Update of the Hospital Outpatient Prospective Payment System | MM6857 |
| 7271 | 01/24/2011 | January 2011 Update of the Hospital Outpatient Prospective Payment System (OPPS) | N/A |
| 6094 | 06/19/2008 | July 2008 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM6094 |
| 5912 | 01/18/2008 | January 2008 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM5912 |
| 5865 | 12/28/2007 | January 2008 Integrated Outpatient Code Editor (I/OCE) Specifications Version 9.0 | MM5865 |
| 5544 | 03/21/2007 | April 2007 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes | N/A |
| 5285 | 03/21/2007 | Provider/Supplier Enrollment Approval Letters | N/A |
| 7271 | 12/30/2010 | January 2011 Update of the Hospital Outpatient Prospective Payment System (OPPS) | N/A |
| 7271 | 12/30/2010 | January 2011 Update of the Hospital Outpatient Prospective Payment System (OPPS) | N/A |
| 5617 | 06/08/2007 | July 2007 Integrated Outpatient Code Editor (I/OCE) Specifications Version 8.2 | MM5617 |
| 5597 | 06/29/2007 | IOM Pub 100-09, Chapters 3, Provider Inquiries and Chapter 6 - Provider Customer Service Program Updates | MM5597 |
| 5597 | 07/13/2007 | IOM Pub. 100-09, Chapters 3- Provider Inquiries and Chapter6- Provider Customer Service Program Updates | N/A |
| 5567 | 07/20/2007 | Reporting of Additional Data to Describe Services on Hospice Claims | N/A |
| 5999 | 04/08/2008 | April 2008 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM5999 |
| 5969 | 03/25/2008 | April 2008 Integrated Outpatient Code Editor (I/OCE) Specifications Version 9.1 | MM5969 |
| 5668 | 11/26/2007 | Adjustment to Payment under Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for Partial Device Credit | N/A |
| 6080 | 05/30/2008 | July 2008 Integrated Outpatient Code Editor (I/OCE) Specifications Version 9.2 | MM6080 |
| 7278 | 03/10/2011 | Affordable Care Act-Section 3113- Laboratory Demonstration for Certain Complex Diagnostic Tests | N/A |
| 7278 | 03/10/2011 | Affordable Care Act-Section 3113- Laboratory Demonstration for Certain Complex Diagnostic Tests | N/A |
| 7344 | 03/11/2011 | April 2011 Integrated Outpatient Code Editor (I/OCE) Specifications Version 12.1 | MM7344 |
| 6967 | 06/04/2010 | July 2010 Integrated Outpatient Code Editor (I/OCE) Specifications Version 11.2 | MM6967 |
| 6996 | 06/04/2010 | July 2010 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM6996 |
| 6953 | 06/04/2010 | Dermal Injections for Treatment of Facial Lipodystrophy Syndrome (LDS) | MM6953 |
| 6953 | 06/04/2010 | Dermal Injections for Treatment of Facial Lipodystrophy Syndrome (LDS) | MM6953 |
| 7010 | 05/28/2010 | Revised Payment Files for the 2010 Ambulatory Surgical Center Payment System | MM7010 |
| 7008 | 06/25/2010 | July 2010 Update to the Ambulatory Surgical Center (ASC) Payment System | MM7008 |
| 7007 | 06/18/2010 | October 2010 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files | MM7007 |
| 7008 | 06/25/2010 | July 2010 Update to the Ambulatory Surgical Center (ASC) Payment System | MM7008 |
| 7029 | 07/08/2010 | Updates to the Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, Outpatient Prospective Payment System (OPPS), and Inpatient Rehabilitation Facility (IRF) PPS Changes due to the Affordable Care Act (ACA) | N/A |
| 7029 | 07/15/2010 | Updates to the Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, Outpatient Prospective Payment System (OPPS), and Inpatient Rehabilitation Facility (IRF) PPS Changes due to the Affordable Care Act (ACA) | MM7029 |
| 6968 | 08/06/2010 | Payment for Implantable Tissue Markers (HCPCS Code A4648) and Implantable Radiation Dosimeters (HCPCS Code A4650) | MM6968 |
| 5285 | 03/21/2007 | Provider/Supplier Enrollment Approval Letters | N/A |
| 5285 | 03/21/2007 | Provider/Supplier Enrollment Approval Letters | N/A |
| 7342 | 03/18/2011 | April 2011 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM7342 |
| 7319 | 03/18/2011 | April Update to the CY 2011 Medicare Physician Fee Schedule Database (MPFSDB) | MM7319 |
| 7147 | 09/10/2010 | October 2010 Update of the Ambulatory Surgical Center (ASC) Payment System | MM7147 |
| 7117 | 09/17/2010 | October 2010 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM7117 |
| 7180 | 10/01/2010 | Maintenance and Update of the Temporary Hook Created to Hold OPPS Claims that Include Certain Drug HCPCS Codes | N/A |
| 7117 | 10/01/2010 | October 2010 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM7117 |
| 7188 | 10/15/2010 | January 2011 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files | MM7188 |
| 6080 | 07/18/2008 | July 2008 Integrated Outpatient Code Editor (I/OCE) Specifications Version 9.2 | MM6080 |
| 6056 | 07/18/2008 | Composite Ambulatory Payment Classification (APC) Processing under the Outpatient Prospective Payment System (OPPS) | N/A |
| 5853 | 02/01/2008 | Use of HCPCS V2787 When Billing Approved Astigmatism-Correcting Intraocular Lens (A-CIOLs) in Ambulatory Surgery Centers (ASCs), Physician Offices, and Hospital Outpatient Departments (HOPDs) | MM5853 |
| 5946 | 02/08/2008 | January 2008 Update of the Hospital Outpatient Prospective Payment System (OPPS)-Manualization | N/A |
| 5880 | 02/01/2008 | Modification of Payment Window Edits in the Common Working File (CWF) to Look at Line Item Dates of Service (LIDOS) on Outpatient Claims | MM5880 |
| 5946 | 02/08/2008 | January 2008 Update of the Hospital Outpatient Prospective Payment System (OPPS)- Manualization | MM5946 |
| 5718 | 09/14/2007 | October 2007 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes | MM5718 |
| 5619 | 05/25/2007 | Update Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for Rate Year (RY) 2008 | N/A |
| 5622 | 05/25/2007 | Important Message from Medicare (IM) and Expedited Determination Procedures for Hospital Discharges | N/A |
| 7357 | 03/25/2011 | July 2011 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files | MM7357 |
| 5723 | 09/21/2007 | October 2007 Integrated Outpatient Code Editor (I/OCE) Specifications Version 8.3 | MM5723 |
| 7111 | 09/03/2010 | October 2010 Integrated Outpatient Code Editor (I/OCE) Specifications Version 11.3 | MM7111 |
| 7219 | 11/19/2010 | Systems Changes Necessary to Implement 'Technical Correction Related to Critical Access Hospital Services', Section 3128 of the Affordable Care Act, Pub. 111-148 | MM7219 |
| 6953 | 11/24/2010 | Dermal Injections for Treatment of Facial Lipodystrophy Syndrome (LDS) | MM6953 |
| 6991 | 11/24/2010 | Calendar Year (CY) 2011 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment | MM6991 |
| 7227 | 11/24/2010 | Instructions for Retrieving the 2011 Pricing and HCPCS Data Files through CMS Mainframe Telecommunications Systems | N/A |
| 7192 | 12/03/2010 | Outlier Reconciliation and other Outlier Manual Updates for the Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System (OPPS), Inpatient Rehabilitation Facility (IRF) PPS, Inpatient Psychiatric Facility (IPF) PPS and Long Term Care Hospital (LTCH) PPS | N/A |
| 6196 | 09/19/2008 | October 2008 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM6196 |
| 6320 | 12/31/2008 | January 2009 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM6320 |
| 6416 | 03/13/2009 | April 2009 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM6416 |
| 7079 | 12/03/2010 | Annual Wellness Visit (AWV), Including Personalized Prevention Plan Services (PPPS) | N/A |
| 7079 | 12/03/2010 | Annual Wellness Visit (AWV), Including Personalized Prevention Plan Services (PPPS) | N/A |
| 5623 | 06/01/2007 | July 2007 Update of the Hospital Outpatient Prospective Payment System (OPPS): Summary of Payment Policy Changes | N/A |
| 5476 | 02/02/2007 | Revisions to the Medicare Physician Fee Schedule (MPFS) Disclosure Format | N/A |
| 5470 | 02/02/2007 | Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) for Oncology Treatment Payment Adjustment | N/A |
| 5522 | 03/09/2007 | April 2007 Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE) Specifications Version 8.1 | N/A |
| 7397 | 05/13/2011 | Pharmacy Billing for Drugs Provided, Incident To,a Physician Service | MM7397 |
| 7439 | 05/20/2011 | July 2011 Integrated Outpatient Code Editor(I/OCE) Specifications Version 12.2 | N/A |
| 6751 | 12/21/2009 | January 2010 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM6751 |
| 7109 | 12/10/2010 | Pharmacy Billing for Drugs Provided Incident to a Physician Service | N/A |
| 7246 | 12/10/2010 | Revisions to the Medicare Code Editor (MCE) and Integrated Outpatient Code Editor (IOCE) Reporting Requirements | N/A |
| 7443 | 05/27/2011 | July 2011 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM7443 |
| 7545 | 09/02/2011 | October 2011 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM7545 |
| 7547 | 08/26/2011 | October 2011 Update of the Ambulatory Surgery Center (ASC) Payment System | MM7547 |
| 7584 | 09/23/2011 | Maintenance and Update of the Temporary Hook Created to Hold OPPS Claims that Include Certain Drug HCPCS Codes | N/A |
| 7624 | 10/27/2011 | January 2012 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files | MM7624 |
| 7464 | 06/17/2011 | Revision to Formula to Compute the Time Value of Money under the Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System (OPPS), Inpatient Rehabilitation Facility (IRF PPS), Inpatient Psychiatric Facility (IPF PPS) and Long Term Care Hospital (LTCH PPS) | N/A |
| 7397 | 07/01/2011 | Pharmacy Billing for Drugs Provided Incident to a Physician Service This CR rescinds and fully replaces CR 7109. | N/A |
| 7672 | 12/29/2011 | January 2012 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM7672 |
| 7672 | 12/29/2011 | January 2012 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM7672 |
| 7682 | 12/29/2011 | January 2012 Update of the Ambulatory Surgery Center Payment System (ASC) | MM7682 |
| 7672 | 01/13/2012 | January 2012 Update of the Hospital Outpatient Prospective Payment System (OPPS) | N/A |
| 7397 | 08/05/2011 | Pharmacy Billing for Drugs Provided Incident To a Physician Service. This CR rescinds and fully replaces CR 7109. | N/A |
| 7541 | 08/19/2011 | October 2011 Integrated Outpatient Code Editor (I/OCE) Specifications Version 12.3 | N/A |
| 7472 | 2012-02-03 | Creation of New Indicator for Use on the Ambulatory Surgical Centers (ASCs) Payment Indicator File for Reporting Quality Measures | N/A |
| 7703 | 2012-02-03 | Interaction of Multiple Procedure Payment Reduction (MPPR) on Imaging Procedures and the Outpatient Prospective Payment System (OPPS) Cap on the Technical Component of Imaging Procedures | MM7703 |
| 7734 | 01/26/2012 | April 2012 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files | MM7734 |
| 7692 | 01/25/2012 | Revised Editing for Hepatitis B Administration Code G0010 | MM7692 |
| 7748 | 2012-03-02 | April 2012 Update of the Hospital Outpatient Prospective Payment System (OPPS) | N/A |
| 7751 | 2012-03-09 | April 2012 Integrated Outpatient Code Editor (I/OCE) Specifications Version 13.1 | MM7751 |
| 7754 | 2012-03-16 | April 2012 Update of the Ambulatory Surgical Center (ASC) Payment System | MM7754 |
| 7692 | 2012-04-04 | Revised Editing for Hepatitis B Administration Code G0010 | N/A |
| 7810 | 2012-04-06 | July 2012 Quarterly Average Sales price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files | MM7810 |
| 7631 | 2012-03-29 | Revised and Clarified Place of Service (POS) Coding Instructions | N/A |
| 7780 | 2012-04-26 | CY 2012 OPPS Payment Adjustment for Certain Cancer Hospitals | N/A |
| 7798 | 2012-04-27 | Update to the Fiscal Intermediary Shared Systems (FISS) Outpatient Provider Specific File (OPSF) for Children’s Hospitals | MM7798 |
| 7771 | 2012-04-27 | New Fiscal Intermediary Shared System (FISS) Edit to Review Medicare Outpatient Prospective Payment System (OPPS) Payments Exceeding Charges | N/A |
| 7771 | 2012-05-04 | New Fiscal Intermediary Shared System (FISS) Edit to Review Medicare Outpatient Prospective Payment System (OPPS) Payments Exceeding Charges. | MM7771 |
| 7841 | 2012-05-11 | July 2012 Integrated Outpatient Code Editor (I/OCE) Specifications Version 13.2 | MM7841 |
| 7854 | 2012-05-25 | July 2012 Update of the Ambulatory Surgical Center Payment System (ASC) | MM7854 |
| 7847 | 2012-06-08 | July 2012 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM7847 |
| 7847 | 2012-06-08 | July 2012 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM7847 |
| 7854 | 2012-06-25 | July 2012 Update of the Ambulatory Surgical Center Payment System (ASC) | MM7854 |
| 7885 | 2012-08-03 | October 2012 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files | MM7885 |
| 7891 | 08/24/2012 | Revised Medicare Summary Notice (MSN) Message Regarding Outpatient Therapy Caps | |
| 8031 | 08/24/2012 | October 2012 Update of the Hospital Outpatient Prospective Payment System (OPPS) | |
| 8011 | 2012-08-31 | Indian Health Services (IHS) Hospital Payment Rates for Calendar Year 2012 | |
| 8061 | 2012-09-14 | Instructions for Retrieving the 2013 Pricing and HCPCS Data Files through CMS' Mainframe Telecommunications Systems | |
| 8065 | 2012-09-28 | Maintenance and Update of the Temporary Hook Created to Hold OPPS Claims that Include Certain Drug HCPCS Codes | |
| 8035 | 2012-09-28 | October 2012 Integrated Outpatient Code Editor (I/OCE) Specifications Version 13.3 | MM8035 |
| 7631 | 2012-09-28 | Revised and Clarified Place of Service (POS) Coding Instructions | MM7631 |
| 7631 | 2012-10-11 | Revised and Clarified Place of Service (POS) Coding Instructions | MM7631 |
| 8116 | 2012-10-26 | January 2013 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files | MM8116 |
| 8107 | 2012-10-26 | Editing Update for Annual Wellness Visit (AWV) | MM8107 |
| 8066 | 2012-11-01 | Update to the Fiscal Intermediary Shared Systems (FISS) for the End Stage Renal Disease (ESRD) Quality Incentive Program (QIP) Adjustments for Children’s Hospitals | |
| 8048 | 2012-11-01 | Enforcing Interim Billing for Partial Hospitalization Services | MM8048 |
| 8005 | 2012-11-30 | Implementing the Claims-Based Data Collection Requirement for Outpatient Therapy Services -- Section 3005(g) of the Middle Class Tax Relief and Jobs Creation Act (MCTRJCA) of 2012 | |
| 8005 | 2012-11-30 | Implementing the Claims-Based Data Collection Requirement for Outpatient Therapy Services -- Section 3005(g) of the Middle Class Tax Relief and Jobs Creation Act (MCTRJCA) of 2012 | MM8005 |
| 8052 | 2012-12-07 | Update to Medicare Deductible, Coinsurance and Premium Rates for 2013 | MM8052 |
| 7631 | 2012-12-14 | Revised and Clarified Place of Service (POS) Coding Instructions | MM7631 |
| 8141 | 2012-12-14 | January 2013 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM8141 |
| 8076 | 2012-12-21 | Implementation of the Hospital Value-Based Purchasing Program and Hospital Readmission Reduction Program for the Rural Community Hospital Demonstration for FY 2013 | MM8076 |
| 8005 | 2012-12-21 | Implementing the Claims-Based Data Collection Requirement for Outpatient Therapy Services -- Section 3005(g) of the Middle Class Tax Relief and Jobs Creation Act (MCTRJCA) of 2012 | MM8005 |
| 8005 | 2012-12-21 | Implementing the Claims-Based Data Collection Requirement for Outpatient Therapy Services -- Section 3005(g) of the Middle Class Tax Relief and Jobs Creation Act (MCTRJCA) of 2012 | MM8005 |
| 8161 | 2012-12-28 | April 2013 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files | |
| 8137 | 2012-12-21 | January 2013 Integrated Outpatient Code Editor (I/OCE) Specifications Version 14.0 | MM8137 |
| 8196 | 2013-02-15 | Bundled Payment for Care Improvement Model 4 – HI and SMI Payment Attribution and Outlier Payments | |
| 8130 | 2013-02-01 | Inpatient Hospital Claims and Medicare Secondary Payer (MSP) Claims with Medicare Coinsurance Days and/or Medicare Lifetime Reserve Days Occurring in the Third or More Calendar Years | |
| 8228 | 2013-03-01 | April 2013 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM8228 |
| 8237 | 2013-03-01 | April 2013 Update of the Ambulatory Surgical Center (ASC) Payment System | MM8237 |
| 8228 | 2013-03-01 | April 2013 Update of the Hospital Outpatient Prospective Payment System (OPPS) | MM8228 |
| 8185 | 2013-03-22 | CMS Administrator’s Ruling: Part A to B Rebilling of Denied Hospital Inpatient Claims | MM8185 |
- Page last Modified: 02/29/2012 1:19 PM
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