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2019 MLN Matters Articles

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Transmittal # Issue Date Subject Implementation Date CR # MM Article # MM Article Release Date
R2218OTN 2019-01-03 ViPS Medicare System (VMS) Prepayment Review File 2019-04-01 10461
R853PI 2019-01-04 Updates to the Appeals Prioritization Process 2019-02-05 10641
R854PI 2019-01-11 Local Coverage Determinations (LCDs) 2019-01-08 10901 MM10901 2019-01-11
R4193CP 2019-01-11 Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.1 Effective April 1, 2019 2019-04-01 11126 MM11126 2019-01-11
R4192CP 2019-01-11 Quarterly Update for the Temporary Gap Period of the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - April 2019 2019-04-01 11097 MM11097 2019-01-11
SE19002 Total Knee Arthroplasty (TKA) Removal from the Medicare Inpatient-Only (IPO) List and Application of the 2-Midnight Rule SE19002 2019-01-08
R4195CP 2019-01-11 New Waived Tests 2019-04-01 11080 MM11080 2019-01-11
R4194CP 2019-01-11 Update to Publication (Pub.) 100-04 Chapter 25 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-12 11091
R4197CP 2019-01-11 Chapter 30 Revisions in Publication (Pub.) 100-04, Medicare Claims Processing Manual 2019-04-15 10848 MM10848 2019-01-11
R2219OTN 2019-01-11 Shared System Enhancement 2018: Enhance Common Working File (CWF) Internal Testing Facility (ITF) Response Records 2019-04-01 10974
R4198CP 2019-01-11 Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) 2018-04-30 10567 MM10567 2019-01-11
R4200CP 2019-01-11 2019 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List 2019-02-12 11085 MM11085 2019-01-11
R2220OTN 2019-01-11 Direct Mailing Notification to MACs Regarding Addressing the Opioid Crisis 2019-02-15 11069
R4199CP 2019-01-11 Clinical Laboratory Fee Schedule – Medicare Travel Allowance Fees for Collection of Specimens 2019-02-12 11146 MM11146 2019-01-11
R310FM 2019-01-11 Notice of New Interest Rate for Medicare Overpayments and Underpayments -2nd Qtr Notification for FY 2019 2019-01-17 11157
R4201CP 2019-01-18 Update to Pub. 100-04 Chapter 1 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19 10916
R212NCD 2019-01-18 Update to Pub. 100-03 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19 11118
R4202CP 2019-01-18 Update to Pub. 100-04 Chapters 8, 20, and 24 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19 10964
R4203CP 2019-01-18 Update to Pub. 100-04 Chapter 32 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19 11079
R4205CP 2019-01-18 Update to Pub. 100-04 Chapter 15 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19 11078
R4204CP 2019-01-17 January 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) 2019-01-07 11099 MM11099 2019-01-18
SE19003 Proof of Delivery Documentation Requirements SE19003 2019-01-17
R2221OTN 2019-01-18 Fiscal Intermediary Standard System (FISS) Prepayment Review Report 2019-01-01 10414
R2222OTN.zip 2019-01-18 Update to the Medicare Fee-For-Service (FFS) Companion Guides 2019-03-01 11131
R4208CP 2019-01-17 Calendar Year (CY) 2019 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment 2019-01-07 11076 MM11076 2019-01-18
R2223OTN 2019-01-18 Multi-Carrier System (MCS) Prepayment Review File 2019-04-01 10460
R4209CP 2019-01-18 Calendar Year (CY) 2019 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule 2019-01-07 11064 MM11064
SE19004 New Electronic System for Provider Reimbursement Review Board Appeals SE19004 2019-01-18
R2224OTN 2019-01-22 ViPS Medicare System (VMS) Prepayment Review File 2019-04-01 10461
R4210CP 2019-01-25 Update to Pub. 100-04 Chapter 10 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-26 11077
R2239OTN 2019-01-24 Targeted Probe and Educate 2017-10-01 10249
R2226OTN 2019-01-25 Synchronize the Common Working File (CWF) and Enrollment Data Base (EDB) Entitlement Data N/A 11052
R2227OTN 2019-01-25 New State Code for CA, FL, LA, MI, MS, OH, PA, TN and TX 2019-07-01 11065
R2228OTN 2019-01-25 Fiscal Intermediary Shared System (FISS) Enhancement of PC Print Billing Software N/A 11070
R2229OTN 2019-01-25 Lock the Claim Term Date on File 41 - Analysis Only 2019-09-01 11107
R2230OTN 2019-01-25 Removal of Quality Programs from the Medicare Physician Fee Schedule (MPFS) Disclosure Report 2019-07-01 11119
R4214CP 2019-01-25 Updates to Reflect Removal of Functional Reporting Requirements and Therapy Provisions of the Bipartisan Budget Act of 2018 2019-02-26 11120 MM11120 2019-01-28
R4213CP 2019-01-25 April 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files 2019-04-01 11151 MM11151 2019-01-28
R4211CP 2019-01-25 Update to Publication (Pub.) 100-04 Chapter 11 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-26 11090
R255BP 2019-01-25 Updates to Reflect Removal of Functional Reporting Requirements and Therapy Provisions of the Bipartisan Budget Act of 2018 2019-02-26 11120 MM11120 2019-01-28
R2240OTN 2019-01-25 User CR: MCS - Print Report Edit/Audit and PJ/PL/PM Set-Up PJ/PL or PL/PM Segments 2019-07-01 10659
R4219CP 2019-01-25 Update to Pub. 100-04 Chapter 34 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-26 11115
R4220CP 2019-01-25 Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process 2019-07-01 11092
R2232OTN 2019-01-25 Revising the Remittance Advice Messaging for the 20-Hour Weekly Minimum for Partial Hospitalization Program (PHP) Services 2019-07-01 11066 MM11087 2019-01-28
R2231OTN 2019-01-25 Processing Veterans Administration (VA) Inpatient Claims Exempt from Present on Admission (POA) Reporting 2019-07-01 11053 MM11053 2019-01-28
R2233OTN 2019-01-25 Shared System Enhancement 2018: Automate Health Insurance Master Record (HIMR) Lookup Within Common Working File (CWF) 2019-07-01 11095
R2235OTN 2019-01-25 Ensuring Organ Acquisition Charges Are Not Included in the Inpatient Prospective Payment System (IPPS) Payment Calculation 2019-07-01 11087 MM11087 2019-01-28
R2234OTN 2019-01-25 Utilizing Data from the USPS Secure Destruction Program to Suppress Mailing Medicare Summary Notices (MSNs) to Undeliverable Addresses 2019-04-01 11075
R2237OTN 2019-01-25 Viable Information Processing Systems (ViPS) Medicare Systems (VMS) Changes to Accommodate National Provider Identifier Associations Analysis and Development 2019-07-01 11096
R2238OTN 2019-01-25 Reduce/Eliminate Screen-Scraping for Shared Systems by Creating Transaction-based Access to Common Working File (CWF) Beneficiary Data - Analysis and Design 2019-07-01 11133
R4222CP 2019-02-01 Update to Intensive Cardiac Rehabilitation (ICR) Programs 2019-03-19 11117 MM11117 2019-02-06
R256BP 2019-02-01 Update to Intensive Cardiac Rehabilitation (ICR) Programs 2019-03-19 11117 MM11117 2019-02-06
R2241OTN 2019-01-29 Enhancing the Verification Process of Common Working File (CWF) Part A Provider Inquiries 2019-04-01 10983 MM10983 2019-01-30
R2243OTN 2019-02-01 International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) N/A 11134 MM11134 2019-02-06
R4229CP 2019-02-01 Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)—Clarification of Payment Rules and Expansion of International Classification of Diseases Tenth Edition (ICD-10) Diagnosis Codes N/A 11022 MM11022 2019-02-06
R4228CP 2019-02-01 Home Health (HH) Patient-Driven Groupings Model (PDGM) - Split Implementation N/A 11081
R4230CP 2019-02-01 Implementation of the Medicare Performance Adjustment (MPA) for the Maryland Total Cost of Care (MD TCOC) Model 2019-07-01 10971
R4227CP 2019-02-01 Independent Laboratory Billing of Laboratory Tests for End-Stage Renal Disease (ESRD) Beneficiaries and the Sunset of the CB Modifier 2019-07-02 11061 MM11061 2019-02-04
R4225CP 2019-02-01 Update to Mammography Editing 2019-07-01 11132
R2247OTN 2019-02-01 Analysis Call to Discuss Multi-Carrier System (MCS) Limitation When Quantity Allowed is Greater Than Quantity Billed 2019-07-01 11149
R2248OTN 2019-02-01 Implementation to Exchange the list of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System 2019-07-01 11003 MM11003 2019-02-04
R2249OTN 2019-02-01 Analysis on Systems to use Documentation Code References in Additional Documentation Request (ADR) Letters and to Include Non-Medical ADRs for Electronic Medical Documentation Requests (eMDRs) via the Electronic Submission of Medical Documentation (esMD) System 2019-07-01 11139
R2250OTN 2019-02-01 User CR: ViPS Medicare System (VMS) changes to the IC4301 - RAC Reopenings and Appeals Tracking Report to Display the Current Appeal Level 2019-07-01 10646
R2244OTN 2019-02-01 Multi-Carrier System (MCS) Analysis Change Request (CR) to create Application Program Interfaces (APIs) for Letter Writing 2019-07-01 11154
R2245OTN 2019-02-01 Processing Instructions to Update the Standard Paper Remit (SPR) 2019-07-01 11112 MM11112 2019-02-04
R2246OTN 2019-02-01 Expand Narrative File Message Number Range Implementation N/A 11156
R4223CP 2019-02-01 File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions 2019-04-01 11138
R2253OTN 2019-02-08 Implementation of Additional Contact with Providers in the Event of a Rejected Cost Report Filing 2019-03-12 10919
R2252OTN 2019-02-08 Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) 2019-07-01 11152 MM11152 2019-02-08
R2251OTN 2019-02-08 Utilizing the Blank Page on Odd-Numbered Medicare Summary Notices to Promote CMS Priorities 2019-07-01 11140
R4232CP 2019-02-08 Update to Publication (Pub.) 100-04 Chapter 26 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12 11129
R41COM 2019-02-08 Update to Publication (Pub.) 100-09 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12 11059
R4236CP 2019-02-08 Update to Publication (Pub.) 100-04 Chapter 3 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12 11083
R4233CP 2019-02-08 Update to Publication (Pub.) 100-04 Chapters 4 and 17 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12 11084
R2255OTN 2019-02-07 Shared System Enhancement 2018: Rewrite Fiscal Intermediary Shared System (FISS) module FSSB6001, Common Working File (CWF) Unsolicited Response Function 2019-10-07 11010
R4234CP 2019-02-08 Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2019 Update 2019-04-01 11163 MM11163 2019-02-08
R4237CP 2019-02-08 Update to the Internet-Only-Manual (IOM) Publication (Pub.) 100-04, Chapter 32, Section 12.1 2019-03-12 11127
R863PI 2019-02-12 Local Coverage Determinations (LCDs) 2019-02-11 10901 MM10901 2019-02-14
R4239CP 2019-02-15 Healthcare Provider Taxonomy Codes (HPTCs) April 2019 Code Set Update N/A 11121 MM11121 2019-02-19
R4238CP 2019-02-15 Combined Common Edits/Enhancements Modules (CCEM) Code Set Update 2019-07-01 11147
R2257OTN 2019-02-15 User CR: MCS - Health Professional Shortage Area (HPSA) No Pay Remittances Should Not Be Sent for Do Not Forward (DNF) Provider 2019-07-01 10656
R2261OTN 2019-02-13 Direct Mailing Notification to MACs Regarding Addressing the Opioid Crisis 2019-02-28 11069
R2260OTN 2019-02-15 User CR: MCS - Add MSP Confirmed Flag and Cost Avoid to History Screen, IDR, and other Files 2019-07-01 10669
R4241CP 2019-02-15 Instructions for Downloading the Medicare ZIP Code Files for July 2019 2019-07-01 11150
R2259OTN 2019-02-15 Modification of the MCS Claims Processing System Logic for Modifier 59, XE, XS, XP, and XU Involving the National Correct Coding Initiative (NCCI) Procedure to Procedure (PTP) Column One and Column Two Codes 2019-07-01 11168 MM11168 2019-02-19
R2258OTN 2019-02-15 User CR: MCS - Display Region on Select MCS Screens 2019-07-01 10657
R4242CP 2019-02-15 April Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule 2019-04-01 11179 MM11179 2019-02-19
R4243CP 2019-02-14 Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process 2019-04-01 10961
R213NCD 2019-02-14 National Coverage Determination (NCD) 20.4 Implantable Cardiac Defibrillators (ICDs) 2019-03-26 10865 MM10865
SE19005 What New Home Health Agencies (HHAs) Need to Know About Being Placed in a Provisional Period of Enhanced Oversight SE19005 2019-02-15
R4244CP 2019-02-15 Home Health (HH) Patient-Driven Groupings Model (PDGM) - Split Implementation N/A 11081 MM11081 2019-02-19
R2263OTN 2019-02-22 Implementation of the Award for the Jurisdiction 8 (J-8) Part A and Part B Medicare Administrative Contractor (J8 A/B MAC) N/A 11153
R4246CP 2019-02-22 Evaluation and Management (E/M) when Performed with Superficial Radiation Treatment 2019-03-25 11137 MM11137 2019-02-25
R866PI 2019-02-22 Update to Chapter 4, Section 4.11 in Publication (Pub.) 100-08 2019-03-25 11058
R867PI 2019-02-22 Update to Exhibit 16 - Model Payment Suspension Letters in Publication (Pub.) 100-08 2019-03-25 11088
R868PI 2019-02-22 Update to Chapter 4, Section 4.7 in Publication (Pub.) 100-08 2019-03-25 11136
R2262OTN 2019-02-21 Ensuring Organ Acquisition Charges Are Not Included in the Inpatient Prospective Payment System (IPPS) Payment Calculation 2019-07-01 11087 MM11087 2019-02-22
R865PI 2019-02-21 Update to Chapter 15 of Publication (Pub.) 100-08 2019-03-12 10954
R4245CP 2019-02-22 Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits 2019-04-01 11135 MM11135 2019-02-25
R2264OTN 2019-02-21 Implementation to Exchange the list of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System 2019-07-01 11003 MM11003 2019-02-22
R311FM 2019-02-22 Updating Chapter 3, Section 200, Limitation on Recoupment; Medicare Overpayments Manual, 2 of 4 CRs. 2019-10-07 10336
R2265OTN 2019-02-25 Revising the Remittance Advice Messaging for the 20-Hour Weekly Minimum for Partial Hospitalization Program (PHP) Services. 2019-07-01 11066 MM11066 2019-02-25
R257BP 2019-03-01 Update to Publication 100-02 Provide Language-Only Changes for the New Medicare Card Project 2019-04-01 11170
R4247CP 2019-03-01 Update to Publication 100-04 Chapters 2, 6, and 18 to Provide Language-Only Changes for the New Medicare Card Project 2019-04-01 11155
SE19006 Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting and Reporting Data for the Private Payor Rate-Based Payment System SE19006 2019-02-27
R2266OTN 2019-02-28 Revising the Remittance Advice Messaging for the 20-Hour Weekly Minimum for Partial Hospitalization Program (PHP) Services 2019-07-01 11066 MM11066 2019-03-01
R186SOMA 2019-03-04 Revisions to State Operations Manual (SOM) Appendix Z, Emergency Preparedness for All Provider and Certified Supplier Types 2019-03-04 N/A
R187SOMA 2019-03-06 Revision to the State Operations Manual (SOM 100-07) Appendix Q 2019-03-06 N/A
R2267OTN 2019-03-06 New State Code for CA, FL, LA, MI, MS, OH, PA, TN and TX N/A 11065
R214NCD 2019-03-06 National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) 2019-04-08 10878 MM10878 2019-03-06
R4250CP 2019-03-08 Update to Chapter 30 in Publication (Pub.) 100-04 to Provide Language-Only Changes for the New Medicare Card Project 2019-04-08 11165
R2268OTN 2019-03-08 Instructions Relating to the Self-Disallowance Requirement for Determining Jurisdiction over Appeals 2019-04-08 10912
R2269OTN 2019-03-07 User CR: MCS - Health Professional Shortage Area (HPSA) No Pay Remittances Should Not Be Sent for Do Not Forward (DNF) Provider 2019-03-07 10656
R5pr242 2019-03-08 Medicare Provider Reimbursement Manual Part 2, Provider Cost Reporting Forms and Instructions, Chapter 42, Form CMS-265-11 2019-03-08 N/A
R4254CP 2019-03-13 Ensuring Only the Active Billing Hospice Can Submit a Revocation 2019-07-01 11049 MM11049 2018-12-28
R2270OTN 2019-03-13 Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) 2019-10-01 11152
R4257CP 2019-03-14 Implementation of the Medicare Performance Adjustment (MPA) for the Maryland Total Cost of Care (MD TCOC) Model 2019-07-01 10971
R4256CP 2019-03-15 April 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.1 2019-04-01 11192 MM11192 2019-03-15
R4255CP 2019-03-15 April 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) 2019-04-01 11216 MM11216 2019-03-19
R4253CP 2019-03-15 Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update 2019-07-01 11204 MM11204 2019-03-15
R4258CP 2019-03-18 Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2019 Update 2019-04-01 11163 MM11163
R870PI 2019-03-22 Manual Updates Related to Home Health Certification and Recertification Policy Changes 2019-04-22 11104 MM11104 2019-03-22
R258BP 2019-03-22 Manual Updates Related to Home Health Certification and Recertification Policy Changes 2019-04-22 11104 MM11104 2019-03-22
R82QRI 2019-03-22 Update to Publication 100-22 to Provide Language-Only Changes for the New Medicare Card Project 2019-04-22 11166
R125MSP 2019-03-22 Update to Publication (Pub.) 100-05 to Provide Language-Only Changes for the New Medicare Card Project 2019-04-22 11193
R4261CP 2019-03-22 Update to the Payment for Grandfathered Tribal Federally Qualified Health Centers (FQHCs) for Calendar Year (CY) 2019 2019-07-01 11203 MM11203 2019-03-22
R4260CP 2019-03-22 Update to Chapter 31 in Publication (Pub.) 100-04 to Provide Language-Only Changes for the New Medicare Card Project 2019-04-22 11178
R4259CP 2019-03-22 Billing for Hospital Part B Inpatient Services 2019-06-21 11181 MM11181 2019-03-22
R4263CP 2019-03-22 April 2019 Update of the Ambulatory Surgical Center (ASC) Payment System 2019-04-19 11232 MM11232 2019-03-22
R4264CP 2019-03-22 July 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files 2019-07-01 11225 MM11225 2019-03-26
R4265CP 2019-03-22 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2019 2019-07-01 11224 MM11224 2019-03-27
R2271OTN 2019-03-29 The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2017 for Inpatient Prospective Payment System (IPPS) Hospitals, Inpatient Rehabilitation Facilities (IRFs), and Long Term Care Hospitals (LTCHs) 2019-04-29 11187 MM11187 2019-03-29
SE19007 Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations SE19007 2019-03-26
R2273OTN 2019-03-29 Revision to the Cost Report Acceptability Checklists 2019-07-01 10920
R4266CP 2019-03-29 Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.2 Effective July 1, 2019 2019-07-01 11227 MM11227 2019-03-29
R4267CP 2019-03-27 Evaluation and Management (E/M) when Performed with Superficial Radiation Treatment 2019-03-25 11137 MM11137 2019-02-25
R871PI 2019-03-29 Update to Section 4.12 in Chapter 4 of Publication (Pub.) 100-08 2019-04-29 11159
R4272CP 2019-03-29 Correction of the Fiscal Year (FY) 2019 Inpatient Prospective Payment System (IPPS) Pricer 2019-07-01 11208 MM11208 2019-03-29
R4271CP 2019-03-29 Update to the Internet-Only-Manual (IOM) Publication (Pub.) 100-04, Chapters 1 and 3 2019-04-29 11188
R872PI 2019-03-29 Updates to Immunosuppressive Guidance 2019-04-18 11172
R4276CP 2019-04-05 Indian Health Services (IHS) Hospital Payment Rates for Calendar Year 2019 2019-05-06 11217
R2275OTN 2019-04-05 User CR: MCS - Add Date to NU Screen for Health Insurance Claim Number (HICN) Changes 2019-10-07 10689
R2276OTN 2019-04-05 Update to Claim Processing Logic to Allow 53 Automated Development System (ADS) Messages (Three Header and 50 Claim Lines) 2019-10-07 11164
R4275CP 2019-04-05 Quarterly Update for the Temporary Gap Period of the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - July 2019 2019-07-01 11233 MM11233 2019-04-08
R312FM 2019-04-05 Updates to Medicare Financial Management Manual Chapter 4, Section 50-50.6 Extended Repayment Schedules 2019-10-07 11128
R875PI 2019-04-05 Updates to Immunosuppressive Guidance 2019-04-18 11172
R215NCD 2019-04-10 National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) N/A 10878 MM10878 2019-04-16
R313FM 2019-04-11 Notice of New Interest Rate for Medicare Overpayments and Underpayments -3rd Qtr Notification for FY 2019 2019-04-17 11286
R2278OTN 2019-04-11 Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) 2019-10-01 11152
R2279OTN 2019-04-12 Direct Mailing Notification to the Medicare Administrative Contractors (MACs) Regarding Clinical Laboratory Fee Schedule (CLFS) 2019-05-03 11271
R876PI 2019-04-12 Update to Publication (Pub.) 100-08 to Provide Language-Only Changes for the New Medicare Card Project 2019-05-13 11109
R32QIO 2019-04-12 Update to Publication (Pub.) 100-10 to Provide Language-Only Changes for the New Medicare Card Project 2019-05-13 11206
R4278CP 2019-04-12 Pub. 100-04, Chapter 29 – Appeals of Claims Decisions - Revisions 2019-06-13 11042 MM11042 2019-04-12
R4277CP 2019-04-12 New Waived Tests 2019-07-01 11231 MM11231 2019-04-15
R2281OTN 2019-04-16 Implementation to Exchange the list of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System 2019-07-01 11003 MM11003 2019-04-19
R2280OTN 2019-04-19 MAC Reporting of Issuance of Compliance Letters to Specific Providers and Suppliers Regarding Inappropriate Billing of Qualified Medicare Beneficiaries (QMBs) for Medicare Cost-Sharing 2019-06-21 11250
R4281CP 2019-04-19 Update to Chapter 28 in Publication (Pub.) 100-04 to Provide Language-Only Changes for the New Medicare Card Project 2019-05-20 11261
R4280CP 2019-04-19 Update to Pub. 100-04, Chapter 11 2019-07-21 11205
R4286CP 2019-04-26 Update to Chapter 21 in Publication (Pub.) 100-04 to Provide Language-Only Changes for the New Medicare Card Project 2019-05-28 11221
R4285CP 2019-04-26 Quarterly Update to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) 2019-07-01 11215 MM11215 2019-04-29
R4284CP 2019-04-26 File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions 2019-07-01 11260
R4283CP 2019-04-26 Documentation of Evaluation and Management Services of Teaching Physicians 2019-07-29 11171 MM11171 2019-05-03
R188SOMA 2019-04-26 Revisions to the State Operations Manual (SOM 100-07) Chapter 2, The Certification Process, Chapter 3, Additional Program Activities, and Chapter 4, Program Administration and Fiscal Management 2019-04-26 N/A
R2282OTN 2019-04-25 Direct Mailing Notification to the Medicare Administrative Contractors (MACs) Regarding Clinical Laboratory Fee Schedule (CLFS) 2019-05-10
R877PI 2019-04-30 Update to Publication (Pub.) 100-08 to Provide Language-Only Changes for the New Medicare Card Project 2019-05-13 11109
R4292CP 2019-05-03 Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - July 2019 Update 2019-07-01 11293 MM11293 2019-05-03
R2295OTN 2019-05-03 Archiving and Retrieving of the Integrated Outpatient Code Editor (I/OCE) for Processing Claims 2019-10-07 11196
R4290CP 2019-05-03 Medicare Summary Notice (MSN) Changes to Assist Beneficiaries Enrolled in the Qualified Medicare Beneficiary (QMB) Program 2019-10-07 11230 MM11230 2019-05-07
R2289OTN 2019-05-03 User CR: FISS Update RPTMEDR1 to Provide Medical Policy Parameters (MPP) Status 2019-10-07 10538
R2290OTN 2019-05-03 User CR: ViPS Medicare System (VMS) - New Standard Paper Remittance (SPR) Files for Use on Durable Medical Equipment Medicare Administrative Contractors (DME MAC) Web Portals 2019-10-07 10722
R2294OTN 2019-05-03 FISS Integrated Outpatient Code Editor (IOCE) Claim Return Buffer Interface Changes Related to New Return Code Field Updates 2019-10-07 11183
R2296OTN 2019-05-03 Updating Fiscal Intermediary Shared System (FISS) for Pricing Drugs at Different Rates Depending on Provider Type 2019-10-07 11199 MM11199 2019-05-03
R2287OTN 2019-05-03 Health Insurance Portability and Accountability Act (HIPAA) Electronic Data Interchange (EDI) Front End Updates for October 2019 2019-10-07 11238
R2297OTN 2019-05-03 Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process 2019-10-07 11209
R4299CP 2019-05-03 Re-implementation of the AMCC Lab Panel Claims Payment System Logic 2019-10-07 11248 MM11248 2019-05-03
R2292OTN 2019-05-03 User CR: FISS - Analysis Only - Enhancement to Allow MACs to Copy VSAM Files from One Region to Another to Reduce File Maintenance 2019-10-07 11018
R4294CP 2019-05-03 Home Health (HH) Patient-Driven Groupings Model (PDGM) - Additional Manual Instructions 2019-08-07 11272 MM11272 2019-05-03
R2298OTN 2019-05-03 International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) 2019-10-07 11229 MM11229 2019-05-07
R2288OTN 2019-05-03 User CR: FISS - Develop Enhanced Claims Search Reporting in FISS - Phase 2 2019-10-07 10534
R2291OTN 2019-05-03 User CR: FISS - Expand Number of Archived Claims That May Be Retrieved per Cycle 2019-10-07 10764
R4298CP 2019-05-03 Medicare Physician Fee Schedule Database (MPFSDB) File Record Layout 2019-10-07 11191 MM11191 2019-05-03
R2285OTN 2019-05-03 Common Working File (CWF) to Medicare Beneficiary Database (MBD) Extract File Changes to send all Hospice periods to Support HIPAA Eligibility Transaction System (HETS) 2019-10-07 11277
R4296CP 2019-05-03 Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment 2019-07-01 11280 MM11280 2019-05-03
R4295CP 2019-05-03 Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04, Chapter 4 2019-08-27 11274
R2293OTN 2019-05-03 Systems Changes to Allow IPPS-Excluded Hospitals to Operate IPPS-Excluded Units 2019-10-07 11173 MM11173 2019-05-03
R3P244 2019-05-03 Medicare Provider Reimbursement Manual Part 2, Provider Cost Reporting Forms and Instructions, Chapter 44, Form CMS-224-14 2019-05-03 N/A
R2299OTN 2019-05-03 Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) 2019-10-01 11152 MM11152 2019-05-07
R2303OTN 2019-05-09 Shared System Enhancement 2018: Rewrite Fiscal Intermediary Shared System (FISS) module FSSB6001, Common Working File (CWF) Unsolicited Response Function N/A 11010
R2305OTN 2019-05-10 Implementation to Send Post-Pay Electronic Medical Documentation Requests (eMDR) to Participating Providers via the Electronic Submission of Medical Documentation (esMD) System N/A 11142
R2304OTN 2019-05-10 Automatic Transmission of the Prepayment File to the Recovery Audit Contractor (RAC) Data Warehouse (DW) 2019-10-17 11256
R2306OTN 2019-05-09 Analysis for First Coast Service Options (FCSO) and Novitas for the CMS Enterprise Identity Management OKTA/Saviynt Migration N/A 10791
R2302OTN 2019-05-10 Implementation to Send Pre-Pay Electronic Medical Documentation Requests (eMDR) to Participating Providers via the Electronic Submission of Medical Documentation (esMD) System 2020-01-06 11141
R2301OTN 2019-05-10 User CR: MCS - Update the RB55 Job to Include Processing of Additional Fields on the Procedure Code File 2019-10-07 10652
R2300OTN 2019-05-10 Reporting the Patient Relationship Categories and Codes 2019-08-12 11259 MM11259 2019-05-16
R123GI 2019-05-10 Updates to Publication (Pub.) 100-01, Medicare General Information, Eligibility, and Entitlement, Chapter 6, Disclosure of Information 2019-06-11 11218
R19PDB 2019-05-10 Update to Publication (Pub.) 100-18 to Provide Language-Only Changes and URL Location Updates for the New Medicare Card Project 2019-06-11 11263
R2308OTN 2019-05-15 New CWF Edit for Part A Outpatient Medicare Advantage (MA), Health Maintenance Organization (HMO) 2019-01-07 10813
R10ESRD 2019-05-17 Update to Publication (Pub.) 100-14 to Provide Language-Only Changes for the New Medicare Card Project 2019-06-18 11284
R4305CP 2019-05-17 Annual Updates to the Prior Authorization/Pre-Claim Review Federal Holiday Schedule Tables for Generating Reports 2019-10-07 11288
R4304CP 2019-05-17 Claim Status Category and Claim Status Codes Update 2019-10-07 11292 MM11292 2019-05-17
R124GI 2019-05-17 Update to Publication (Pub.) 100-01 to Provide Language-Only Changes for the New Medicare Card Project 2019-06-08 11240
R4306CP 2019-05-17 Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - July 2019 Update 2019-07-01 11296 MM11296 2019-05-20
R4303CP 2019-05-17 Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update 2019-10-07 11252 MM11252 2019-05-17
R2307OTN 2019-05-17 Additional Processing Instructions to Update the Standard Paper Remit (SPR) 2019-10-07 11289 MM11289 2019-05-21
R126MSP 2019-05-17 Update the International Classification of Diseases, Tenth Revision (ICD-10) 2020 Tables in the Common Working File (CWF) for Purposes of Processing Non-Group Health Plan (NGHP) Medicare Secondary Payer (MSP) Records and Claims 2019-10-07 11158
R315FM 2019-05-17 Update to Publication (Pub.) 100-06 to Provide Language-Only Changes for the New Medicare Card Project 2019-06-18 11211
R2309OTN 2019-05-17 New Overpayment Field Established within the ViPS Medicare System (VMS) for Healthcare Integrated General Ledger Accounting System (HIGLAS) Reporting N/A 11297
R4307CP 2019-05-17 Instructions for Downloading the Medicare ZIP Code Files for October 2019 2019-10-07 11267
R4308CP 2019-05-16 Implementation of the Medicare Performance Adjustment (MPA) for the Maryland Total Cost of Care (MD TCOC) Model 2019-07-01 10971
R2310OTN 2019-05-17 Viable Information Processing Systems (ViPS) Medicare Systems (VMS) Changes to Accommodate National Provider Identifier Associations Analysis and Development N/A 11096
R4310CP 2019-05-24 Combined Common Edits/Enhancements Modules (CCEM) Code Set Update 2019-10-07 11301
R189SOMA 2019-05-24 New to State Operations Manual (SOM), Appendix X, Survey Protocol and Interpretive Guidelines for Organ Transplant Programs 2019-05-24 N/A
R316FM 2019-05-24 Updates to Medicare Financial Management Manual Chapter 4, Section 20 and 20.1 Demand Letters 2019-10-07 10776
R2311OTN 2019-05-24 New Bills Pending Reports to Assist Medicare Administrative Contractors (MACs) with Monthly Status Report (MSR) 2019-05-24 11257
R882PI 2019-05-24 Additional Processing Procedure for Adding a New Provider-Based Location for Critical Access Hospitals (CAHs) 2019-06-25 11246
R4309CP 2019-05-24 Documentation of Medical Necessity of the Home Visit; and Physician Management Associated with Superficial Radiation Treatment 2019-08-27 11273 MM11273 2019-05-29
R4312CP 2019-05-23 Home Health (HH) Patient-Driven Groupings Model (PDGM) - Additional Manual Instructions 2019-08-16 11272 MM11272 2019-05-24
R4313CP 2019-05-24 July 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) 2019-07-01 11318 MM11318 2019-05-30
R4314CP 2019-05-24 July 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.2 2019-07-01 11298 MM11298 2019-05-31
SE19009 Chimeric Antigen Receptor (CAR) T-Cell Therapy Revenue Code and HCPCS Setup Revisions SE19009 2019-05-28
R4315CP 2019-05-31 Annual (2020) Update of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) 2019-10-07 11322
R883PI 2019-05-31 Update to Chapter 12 (The Comprehensive Error Rate Testing (CERT) Program) of Publication (Pub) 100-08 (Medicare Program Integrity Manual) 2019-08-29 11283
R884PI 2019-05-31 Update to Exhibit 46.2, 46.3, 46.4, and 46.5 in Publication (Pub.) 100-08 2019-08-30 11242 MM11242 2019-05-31
R4317CP 2019-06-07 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 2019-10-07 11321 MM11321 2019-06-10
R2313OTN 2019-06-10 FISS Integrated Outpatient Code Editor (IOCE) Claim Return Buffer Interface Changes Related to New Return Code Field Updates 2019-10-07 11183
R4320CP 2019-06-12 Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - July 2019 Update 2019-07-01 11296 MM11296 2019-06-19
R4321CP 2019-06-14 July Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule 2019-07-01 11334 MM11334 2019-06-25
R4319CP 2019-06-14 July 2019 Update of the Ambulatory Surgical Center (ASC) Payment System 2019-07-01 11328 MM11328 2019-07-16
R190SOMA 2019-06-14 Updates to the State Operations Manual (SOM) Chapters 2, 3 and 9 to add instructions for Organ Transplant Programs. 2019-06-14 N/A
R2315OTN 2019-06-14 Mobile Personal Identity Verification (PIV) Station Pilot Project 2019-07-16 11304
R2316OTN 2019-06-25 Fiscal Intermediary Shared System (FISS) Enhancement of PC Print Billing Software N/A 11070
SE19012 Emergency Medical Treatment and Labor Act (EMTALA) and the Born-Alive Infant Protection Act SE19012 2019-06-27
SE19001 Pre-Diabetes Services: Referring Patients to the Medicare Diabetes Prevention Program SE19001 2019-06-27
R4325CP 2019-06-28 Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2020 2019-10-01 11347 MM11347 2019-07-02
R227DEMO 2019-06-28 Next Generation ACO Model - Demo Code Placement 2019-10-07 11340
R2317OTN 2019-06-28 Possible Use of Session Initiation Protocol (SIP) at Medicare Administrative Contractors (MACs) 2019-07-30 11308
R4326CP 2019-06-28 Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment 2019-07-01 11280 MM11280 2019-07-02
R4327CP 2019-06-28 July 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.2 2019-07-01 11298 MM11298 2019-07-03
R4328CP 2019-06-28 July Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule 2019-07-01 11334 MM11334 2019-07-02
SE19011 Reduce Risk of Opioid Overdose Deaths by Avoiding and Reducing Co-Prescribing Benzodiazepines SE19011 2019-07-01
R2318OTN 2019-07-02 New Bills Pending Reports to Assist Medicare Administrative Contractors (MACs) with Monthly Status Report (MSR) 2019-10-07 11257
R4332CP 2019-07-03 Medicare Summary Notice (MSN) Changes to Assist Beneficiaries Enrolled in the Qualified Medicare Beneficiary (QMB) Program 2019-10-07 11230 MM11230 2019-07-09
R4331CP 2019-07-05 October 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files 2019-10-07 11343 MM11343 2019-07-09
R4330CP 2019-07-05 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2019 2019-10-07 11344 MM11344 2019-07-12
R4329CP 2019-07-05 Quarterly Update for the Temporary Gap Period of the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - October 2019 2019-10-07 11336 MM11336 2019-07-15
R125GI 2019-07-05 Internet Only Manual (IOM) - Update to General Information, Eligibility, and Entitlement, Chapter 7 - Contract Administrative Requirements, Section 40.2 – Shared System Maintainer Responsibilities for Systems Releases, Section 40.3.11 Single Testing Contractor (STC) Non-Testable Conditions and Potential Testing Impacts 2019-08-05 11245
R2319OTN 2019-07-05 Implementation to Send Pre-Pay Electronic Medical Documentation Requests (eMDR) to Participating Providers via the Electronic Submission of Medical Documentation (esMD) System 2020-01-06 11141
R2320OTN 2019-07-08 2019-10-07 11183
SE19013 Medicare Plans to Modernize Payment Grouping and Code Editor Software SE19013 2019-07-10
R259BP 2019-07-12 Update to Coverage of Intravenous Immune Globulin for Treatment of Primary Immune Deficiency Diseases in the Home 2019-08-13 11295 MM11295 2019-07-15
R2321OTN 2019-07-12 Fee For Service (FFS) Applications Upgrade Customer Information Control System (CICS) to Transaction Server (TS) v5.4 and Liberty Profile Functionality N/A 11162
R4334CP 2019-07-12 Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.3 Effective October 1, 2019 2019-10-07 11357 MM11357 2019-07-15
R318FM 2019-07-12 Notice of New Interest Rate for Medicare Overpayments and Underpayments -4th Qtr Notification for FY 2019 2019-07-17 11396
SE19014 Tropical Storm Barry and Medicare Disaster Related Louisiana Claims SE19014 2019-07-15
R4337CP 2019-07-18 Implementation of the Medicare Performance Adjustment (MPA) for the Maryland Total Cost of Care (MD TCOC) Model 2019-07-01 10971
R191SOMA 2019-07-19 Revisions to the State Operations Manual (SOM) Chapter 5 and Appendix V 2019-07-19 N/A
R4336CP 2019-07-19 New Waived Tests 2019-10-07 11354 MM11354 2019-07-23
R2322OTN 2019-07-18 Possible Use of Session Initiation Protocol (SIP) at Medicare Administrative Contractors (MACs) - Analysis Only 2019-07-25 11308
R2324OTN 2019-07-24 Implementation to Send Pre-Pay Electronic Medical Documentation Requests (eMDR) to Participating Providers via the Electronic Submission of Medical Documentation (esMD) System 2020-01-06 11141
R2323OTN 2019-07-26 Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging – Educational and Operations Testing Period - Claims Processing Requirements 2020-01-06 11268 MM11268 2019-07-26
R2325OTN 2019-07-24 Implementation to Send Post-Pay Electronic Medical Documentation Requests (eMDR) to Participating Providers via the Electronic Submission of Medical Documentation (esMD) System N/A 11142
R4339CP 2019-07-25 Documentation of Medical Necessity of the Home Visit; and Physician Management Associated with Superficial Radiation Treatment 2019-08-27 11273 MM11273 2019-05-29
R2326OTN 2019-07-31 Oxygen Policy Update 2019-01-07 10837 MM10837 2019-08-02
R2330OTN 2019-08-02 Medicare Shared Savings Program (SSP) Skilled Nursing Facility (SNF) Affiliates' Requirement to Include Demonstration Code 77 on SNF Waiver Claims 2020-01-06 11290 MM11290 2019-08-05
R4347CP 2019-08-02 Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment 2019-10-07 11406 MM11406 2019-08-02
R2331OTN 2019-08-02 Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process 2020-01-01 11307 MM11307 2019-08-02
R4341CP 2019-08-02 October Quarterly Update to 2019 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement 2019-10-07 11381 MM11381 2019-08-02
R2332OTN 2019-08-02 Health Insurance Portability and Accountability Act (HIPAA) Electronic Data Interchange (EDI) Front End Updates for January 2020 2020-01-06 11241
R2333OTN 2019-08-02 Update Encounter Data Version of Combined Common Edit Module (CCEM) to Use Receipt Date 2020-01-06 11365
R2335OTN 2019-08-02 Instructions for Use of Informational Remittance Advice Remark Code Alert on Laboratory Service Remittance Advices 2020-01-06 11369 MM11369 2019-08-02
R2334OTN 2019-08-02 Technical Change: Modification to Durable Medical Equipment (DME) Claims Cancellation Process 2020-01-06 11379
R4353CP 2019-08-02 Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2020 2019-10-07 11345 MM11345 2019-08-02
R2329OTN 2019-08-02 Automation of Part B Underpayment Processing of Recovery Audit Contractor (RAC) Adjustments 2020-01-06 11285
R321FM 2019-08-09 The Fiscal Intermediary Shared System (FISS) Submission of Copybook Files to the Provider and Statistical Reimbursement (PS&R) System 2020-01-06 11359
R4356CP 2019-08-09 File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions 2019-10-07 11378
R2342OTN 2019-08-09 Supplemental to Change Request (CR) 10829 Medicare Appeals System (MAS) Data Collection Web Services Pilot (DCP) Additional Appeals Reporting Requirements for the Pilot Jurisdictions (JD and J15) 2019-11-12 11376
R4357CP 2019-08-09 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Updates for Fiscal Year (FY) 2020 2019-10-07 11420 MM11420 2019-08-12
R2339OTN 2019-08-09 User CR: ViPS Medicare System (VMS) Changes to Provide Cross Copy Functionality for Multiple SuperOp Events and Value Sets 2020-01-06 10890
R228DEMO 2019-08-09 Display PARHM Claim Payment Amounts 2020-01-06 11355 MM11355 2019-08-09
R2336OTN 2019-08-09 User CR: ViPS Medicare System (VMS) changes for Auto-Removal of Certificates of Medical Necessity (CMNs) associated with Super-Deleted Initial CMNs 2020-01-06 11145
R2337OTN 2019-08-09 User CR: MCS - Enhance CA Screen to Display Initial Transactions on an Adjustment 2020-01-06 10662
R2340OTN 2019-08-09 User Change Request: Fiscal Intermediary Standard System (FISS) - SC10 File Fix Utility Enhancement 2020-01-06 10774
R2341OTN 2019-08-09 Shared System Enhancement 2018: Minimize Data Elements on Daily Extracts to Medicare Beneficiary Database (MBD) and Next Generation Desktop (NGD) 2020-01-06 11324
R2338OTN 2019-08-09 Bypassing Payment Window Edits for Donor Post-Kidney Transplant Complication Services 2020-01-06 11312 MM11312 2019-08-09
R2348OTN 2019-08-09 International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--January 2020 Update 2020-01-06 11392 MM11392 2019-08-12
R2349OTN 2019-08-09 Solutions to the Medicare Administrative Contractor (MAC) Prepayment Review Reports 2020-01-06 11326
R2344OTN 2019-08-09 User Change Request: FISS - Bypass 38021 for New Patient Discharge Status 2020-01-06 10772
R2343OTN 2019-08-09 Expand Other Amounts Indicator to Carry Additional Values N/A 11387
R2346OTN 2019-08-09 User Change Request (CR): Fiscal Intermediary Shared System (FISS) - Add Tape Flags W, T, and O to the 6H Status Location (SLOC) Function 2020-01-06 10765
R2345OTN 2019-08-09 Integrated Data Repository (IDR) Weekly Scheduled Full Provider Master File (PMF) Extracts 2020-01-06 11299
R2347OTN 2019-08-09 Integrated Data Repository (IDR) Weekly Scheduled Full Provider Master File (PMF) Extracts 2020-01-06 11305
R4364CP 2019-08-16 Manual Update to Sections 1.2 and 10.2.1 in Chapter 18 of Publication (Pub.) 100-04 2019-11-18 11403 MM11403 2019-08-16
R4363CP 2019-08-16 Update to Hospice Payment Rates, Hospice Cap, Hospice Wage Index and Hospice Pricer for FY 2020 2019-10-07 11411 MM11411 2019-08-20
R4362CP 2019-08-16 Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - October 2019 Update 2019-10-07 11402 MM11402 2019-08-16
R2351OTN 2019-08-16 User Change Request: Fiscal Intermediary Standard System (FISS) - Wage Index for End Stage Renal Disease (ESRD) Providers Incorrect on MAP1C15 2020-01-06 10759
R2350OTN 2019-08-16 User Change Request: Fiscal Intermediary Standard System (FISS) - Autopopulate the Line Item User Action Code for Hard Coded 59XXX Reason Codes 2020-01-06 11382
R2353OTN 2019-08-16 User CR: MCS - Updates to Beneficiary Deliverable Logic for Internal/Clerk Duplicate Medicare Summary Notices (MSNs) and Temporary Addresses 2020-01-06 10660
R229DEMO 2019-08-16 Next Generation and Vermont ACO Model - AIPBP Reduction File and BE Modifications 2020-01-06 11350
R2352OTN 2019-08-16 User Change Request: Fiscal Intermediary Standard System - Online PARM 6L Line Numbers 2020-01-06 10755
R4367CP 2019-08-16 Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - October 2019 Update 2019-10-07 11422 MM11422 2019-08-16
R4368CP 2019-08-15 Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2020 2019-10-07 11345 MM11345 2019-08-15
R8P233 2019-08-16 Updates Chapter 33, Organ Procurement Organization and Tissue Typing Laboratory Cost Reports, Form CMS-216-94 to incorporate data previously reported on OMB No. 0938-0301, the Provider Cost Report Reimbursement Questionnaire, Form CMS-339. N/A N/A
SE19008 Medicare Coverable Services for Integrative and Nonpharmacological Chronic Pain Management SE19008 2019-08-19
R4375CP 2019-08-23 Instructions for Downloading the Medicare ZIP Code File for January 2020 2020-01-06 11405
R7374CP 2019-08-23 2020 Healthcare Common Procedure Coding System (HCPCS) Annual Update Reminder 2020-01-06 11407
R4371CP 2019-08-23 Healthcare Provider Taxonomy Codes (HPTCs) October 2019 Code Set Update N/A 11418 MM11418 2019-08-23
R4370CP 2019-08-23 Combined Common Edits/Enhancements Modules (CCEM) Code Set Update 2020-01-06 11367
R4377CP 2019-08-23 Claim Status Category and Claim Status Codes Update 2020-01-06 11393 MM11393 2019-08-23
R4376CP 2019-08-23 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 2020-01-06 11394 MM11394 2019-08-23
SE19015 New Documentation Requirements for Filing Medicare Cost Reports SE19015 2019-08-21
R4378CP 2019-08-23 Home Health (HH) Patient-Driven Groupings Model (PDGM) - Revised and Additional Manual Instructions 2019-11-27 11395 MM11395 2019-08-23
R4379CP 2019-08-23 2020 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments 2020-01-06 11437 MM11437 2019-08-23
R2355OTN 2019-08-28 Implementation to Send Post-Pay Electronic Medical Documentation Requests (eMDR) to Participating Providers via the Electronic Submission of Medical Documentation (esMD) System N/A 11142
R4384CP 2019-08-30 Annual Clotting Factor Furnishing Fee Update 2020 2020-01-06 11435 MM11435 2019-09-03
R4385CP 2019-08-30 2020 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update 2020-01-06 11441 MM11441 2019-09-03
R2354OTN 2019-08-30 Utilizing the Blank Page on Odd-Numbered Medicare Summary Notices to Promote CMS Priorities: All MACs - This CR Rescinds and Fully Replaces CR 11140. 2020-01-06 11364
R4383CP 2019-08-30 October 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.3 2019-10-07 11412 MM11412 2019-09-03
R4382CP 2019-08-30 Influenza Vaccine Payment Allowances - Annual Update for 2019-2020 Season N/A 11428 MM11428 2019-09-03
R4381CP 2019-08-30 Updates to Chapter 1 Payer Only Codes in the Medicare Claims Processing Manual 2019-10-01 11414
R4380CP 2019-08-30 Pub. 100-04, Chapter 29 – Appeals Signature Requirement Changes 2019-10-01 11352
R896PI 2019-08-30 Updates to Provider Enrollment Processing Instructions in Chapter 15 of Publication (Pub.) 100-08 2019-10-01 11325
R4386CP 2019-08-30 October Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule 2019-10-07 11433 MM11433 2019-09-03
R2356OTN 2019-08-30 Utilizing Data from the USPS Secure Destruction Program to Suppress Mailing Medicare Summary Notices (MSNs) to Undeliverable Addresses: Implementation by All MACs - This CR Rescinds and Fully Replaces CR 11075. 2020-01-06 11363
R4387CP 2019-08-30 October 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) 2019-10-07 11451 MM11451 2019-09-03
SE19017 Hurricane Dorian and Medicare Disaster Related Commonwealth of Puerto Rico Claims SE19017 2019-08-30
SE19018 Hurricane Dorian and Medicare Disaster Related State of Florida Claims SE19018 2019-09-03
SE19019 Hurricane Dorian and Medicare Disaster Related States of Georgia and South Carolina claims SE19019 2019-09-04
SE19020 Hurricane Dorian and Medicare Disaster Related State of North Carolina Claims SE19020 2019-09-05
R128MSP 2019-09-06 Electronic Correspondence Referral System (ECRS) New Consolidated Workload Search 2019-10-07 11366
R2357OTN 2019-09-06 Additional Instructions to Hospitals on the Election of a Medicare-Supplemental Security Income (SSI) Component of the Disproportionate Share (DSH) Payment Adjustment for Cost Reports that Involve SSI Ratios for Fiscal Year (FY) 2004 and Earlier, or SSI Ratios for Hospital Cost-Reporting Periods for Patient Discharges Occurring Before October 1, 2004 2019-12-09 10484 MM10484 2019-09-06
R4388CP 2019-09-06 Manual Updates to Chapters 1, 22, 24, 26, and 31 in Publication (Pub.) 100-04 2019-10-07 11331
R4389CP 2019-09-06 October 2019 Update of the Ambulatory Surgical Center (ASC) Payment System 2019-10-07 11457 MM11457 2019-09-09
R2358OTN 2019-09-06 Implementation of the Award for the Jurisdiction H Part A and Part B Medicare Administrative Contractor (JH A/B MAC) 2019-09-30 11421
R898PI 2019-09-06 Updates to Provider Enrollment Processing Instructions in Chapter 15 of Publication (Pub.) 100-08, Program Integrity Manual, and to the CMS-855R Processing Guide 2019-10-07 11371
R2359OTN 2019-09-05 User CR: ViPS Medicare System (VMS) Changes to Provide Cross Copy Functionality for Multiple SuperOp Events and Value Sets 2020-01-06 10890
R192SOMA 2019-09-06 Revisions to State Operations Manual (SOM), Appendix Q 2019-09-06 N/A
R4391CP 2019-09-06 Implementation of the Medicare Performance Adjustment (MPA) for the Maryland Total Cost of Care (MD TCOC) Model 2019-07-01 10971
R2360OTN 2019-09-06 Integrated Data Repository (IDR) Weekly Scheduled Full Provider Master File Extracts 2020-01-06 11299
SE19022 2019-2020 Influenza (Flu) Resources for Health Care Professionals SE19022 2019-09-09
R2361OTN 2019-09-10 Solutions to the Medicare Administrative Contractor (MAC) Prepayment Review Reports 2020-01-06 11326
R4392CP 2019-09-13 Instructions for Retrieving the January 2020 Medicare Physician Fee Schedule Database (MPFSDB) Files Through the CMS Mainframe Telecommunications System 2020-01-06 11385
R4393CP 2019-09-13 Internet Only Manual Update to Add New and Revise Sections of Publication 100-04, Chapter 11 2019-11-25 11431
R4394CP 2019-09-13 Billing for Hospital Part B Inpatient Services 2019-10-19 11413 MM11413 2019-09-13
R4395CP 2019-09-13 October 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files 2019-10-07 11343 MM11343 2019-09-16
R4396CP 2019-09-17 Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - October 2019 Update 2019-10-07 11422 MM11422 2019-09-18
R4397CP 2019-09-20 Quarterly Update for the Temporary Gap Period of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) - January 2020 2020-01-06 11462 MM11462 2019-09-20
R193SOMA 2019-09-20 Revisions to Medicare State Operations Manual (SOM) Chapter 2 2019-09-20 N/A
R2362OTN 2019-09-19 International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs)--January 2020 Update 2020-01-06 11392 MM11392 2019-08-12
R2364OTN 2019-09-25 User Change Request: Fiscal Intermediary Standard System (FISS) - Autopopulate the Line Item User Action Code for Hard Coded 59XXX Reason Codes 2020-01-06 11382
R2363OTN 2019-09-25 Instructions Relating to the Self-Disallowance Requirement for Determining Jurisdiction over Appeals 2020-03-08 10912
R905PI 2019-09-27 Update to Chapter 12 (The Comprehensive Error Rate Testing (CERT) Program) of Publication (Pub.) 100-08 2019-12-30 11329
R906PI 2019-09-02 Guidance Regarding the Use of Statistical Sampling for Overpayment Estimation 2019-01-02 10067
R4400CP 2019-09-27 Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2020 2020-01-06 11485 MM11485 2019-09-30
R902PI 2019-09-27 2019-10-28 11425
R4404CP 2019-09-27 January 2020 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files 2020-01-06 11495 MM11495 2019-09-30
R904PI 2019-09-27 Provider Enrollment Rebuttal Process 2019-12-31 10978 MM10978 2019-09-30
R479PR1 2019-09-27 The language in the initial paragraph of this section and adds Table 31 to update the Medicare Payment Rates. N/A N/A
R4406CP 2019-10-01 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Updates for Fiscal Year (FY) 2020 2019-10-07 11420 MM11420 2019-10-02
R2367OTN 2019-10-03 Integrated Data Repository (IDR) Weekly Scheduled Full Provider Master File Extracts 2020-01-06 11299
R2369OTN 2019-10-04 Implementation for First Coast Service Options (FCSO) and Novitas for the CMS Enterprise Identity Management OKTA/Saviynt Migration 2020-03-31 11452
R4407CP 2019-10-04 Ambulance Inflation Factor for Calendar Year (CY) 2020 and Productivity Adjustment 2020-01-06 11497 MM11497 2019-10-04
R2368OTN 2019-10-04 Reconciliation Effort Between Shared Systems and Provider Enrollment Chain and Ownership System (PECOS) 2019-11-05 11427
R907PI 2019-10-04 Update to Chapter 3, Section 3.2.3.1 Additional Documentation Requests (ADR) of Publication (Pub) 100-08 2020-01-06 10828
SE0821 Reminder – Medicare Provides Coverage of Diabetes Screening Tests SE0821
R326FM 2019-10-04 The Medicare Fee-for-Service Recovery Audit Program 2019-11-04 11464
R908PI 2019-10-04 The Medicare Fee-for-Service Recovery Audit Program 2019-11-05 11464
R261BP 2019-10-04 Manual Updates for CR11152 Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) 2019-11-05 11454
R4409CP 2019-10-04 Manual Updates for CR11152 Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) 2019-11-05 11454
R126GI 2019-10-04 Manual Updates for CR11152 Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) 2019-11-05 11454
R4410CP 2019-10-04 October 2019 Update of the Ambulatory Surgical Center (ASC) Payment System 2019-10-07 11457 MM11457 2019-10-07
R4411CP 2019-10-04 October 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) 2019-10-07 11451 MM11451
R4390CP 2019-10-07 Fiscal Year (FY) 2020 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Changes 2019-10-07 11361 MM11361 2019-10-08
R2370OTN 2019-10-08 Integrated Data Repository (IDR) Weekly Scheduled Full Provider Master File Extracts 2020-01-06 11299
R2371OTN 2019-10-09 New Overpayment Field Established within the ViPS Medicare System (VMS) for Healthcare Integrated General Ledger Accounting System (HIGLAS) Reporting N/A 11297
R2372OTN 2019-10-11 Add Dates of Service (DOS) for Pneumococcal Pneumonia Vaccination (PPV) Health Care Procedure Code System (HCPCS) Codes (90670, 90732), and remove Next eligible dates for PPV HCPCS. N/A 11335 MM11335 2019-10-11
R4412CP 2019-10-11 File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions 2020-01-06 11515
R4415CP 2019-10-11 Medicare Administrative Contractor (MAC) Guidance Related to Use of Adjustment Codes on Adjustment Claims 2020-01-06 11113
R2373OTN 2019-10-10 Home Health Orders for Nurse Practitioners under the Maryland Total Cost of Care (TCOC) Model 2020-01-06 11330 MM11330 2019-10-11
R327FM 2019-10-11 Notice of New Interest Rate for Medicare Overpayments and Underpayments -1st Qtr Notification for FY 2020 2019-10-18 11543
R2374OTN 2019-10-18 Updating Calendar Year (CY) 2020 Medicare Diabetes Prevention Program (MDPP) Payment Rates 2020-01-06 11455 MM11455 2019-10-18
R2375OTN 2019-10-18 Advanced Provider Screening (APS) Phase 2 Go-Live 2019-11-18 11174
11463 2019-10-18 Medicare Administrative Contractor (MAC) Verification of Potential Errors and Corrective Actions Taken 2019-11-19 11463
R480PRI 2019-10-17 To update the language in the initial paragraph of this section and adds Table 31 to update the Medicare Payment Rates for routine SNF-type services by swing-bed hospitals during calendar year 2020. N/A N/A
R328FM 2019-10-18 Updates to Medicare Financial Management Manual Chapter 4, Section 50-50.6 Extended Repayment Schedules 2019-10-07 11128
R230DEMO 2019-10-21 Next Generation and Vermont ACO Model - AIPBP Reduction File and BE Modifications 2020-01-06 11350