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Wednesday, July 3, 2024


Claims, Pricers, & Codes

MLN Matters® Articles




ESRD Prospective Payment System CY 2025 Proposed Rule — Submit Comments by August 26 

CMS issued the CY 2025 ESRD Prospective Payment System proposed rule to propose updates for Medicare ESRD: 

  • Payment policies and rates
  • Wage index methodology:
    • Combines data from the Bureau of Labor Statistics Occupation Employment Wage & Statistics and freestanding ESRD facility cost reports
    • Comments are encouraged
  • Conditions for coverage 
  • Quality Incentive Program
  • Treatment Choices Model

See a summary of proposed provisions. Comments are due by August 26, 2024; see the proposed rule for details on how to submit them.

CMS Roundup (June 28, 2024)

You may be interested in this topic from the CMS Roundup: Updated Roadmap to Better Care for American Indians and Alaska Natives.

Improve Your Search Results for CMS Content 

If you’re using a search engine to find information on CMS.gov, include “CMS” in your search term to get optimal results.


Claims, Pricers, & Codes

RARCs, CARCs, Medicare Remit Easy Print, & PC Print: July Update 

Get updated remittance advice remark codes (RARCs) and claim adjustment reason codes (CARCs), and watch for software updates if you use Medicare Remit Easy Print or PC Print.

More Information:

MLN Matters® Articles

Changes to the Laboratory National Coverage Determination Edit Software: October 2024 Update 

Learn about edit software updates (PDF) effective October 1, 2024:

  • New and changed codes
  • How to find coding information

Your Medicare Administrative Contractor will adjust claims they processed in error that you bring to their attention.

Ambulatory Surgical Center Payment Update – July 2024 — Revised 

Learn what’s changed (PDF). CMS removed HCPCS codes J3393, J3394, J9172, J9322, and J9324 from attachment A, table 2 of the change request, which now has 12 codes.

Diabetes Screening & Definitions Update: CY 2024 Physician Fee Schedule Final Rule — Revised 

Learn what’s changed (PDF). CMS clarified claims processing requirements for ICD-10-CM diagnosis code Z13.1.

Medicare Administrative Contractors will adjust claims with dates of service on or after January 1, 2024, that you bring to their attention.



Medicare Part D Vaccines — Revised 

Learn what’s changed (PDF). CMS clarified policies on:

  • New vaccines and plan formularies
  • Billing

Update your link if you previously bookmarked it.

Period of Enhanced Oversight for New Hospices in Arizona, California, Nevada, & Texas — Revised 

Learn what’s changed (PDF). CMS clarified the period of enhanced oversight for reactivating hospices.


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