News
- Alabama: $144M to Improve Mental Health, Substance Abuse, Emergency, and Maternal Care & Expand the Health Care Workforce
- Alaska: $160M to Bring Cutting-Edge Technology, Drones Prescription Deliveries, Surgical Robotics & More
- North Dakota: Critical Funding to Launch the Coordinating & Connecting Care Initiative
- Ohio: $3.15M to Expand Pharmacy Connectivity Throughout Rural Communities
- Pennsylvania: $35M to Advance Screening Technology, Secure Additional Operating Rooms & Modernize Rural Health Care
- South Dakota: $90M to Modernize & Improve IT and Interoperability
- West Virginia: $4.2M to Expand Medical Transportation & Improve Patient Access to Care
Compliance
Claims, Pricers & Codes
MLN Matters® Articles
- Clinical Laboratory Fee Schedule & Clinical Laboratory Improvement Amendments HCPCS Codes, Waived Tests & Reasonable Charge Payments: October 2026 Quarterly Update
- Hospice Payments: FY 2027 Update
- ICD-10 & Other Coding Revisions to National Coverage Determinations: January 2027 Update (2 of 2)
News
Alabama: $144M to Improve Mental Health, Substance Abuse, Emergency, and Maternal Care & Expand the Health Care Workforce
This federal investment will help strengthen the rural health workforce, expand care options, and modernize health care delivery across Alabama.
The Trump Administration announced that a $144 million investment is being delivered to improve health outcomes for Alabamians through the federal Rural Health Transformation Program. This investment will support 138 grants to expand access to care, modernize health care technology and infrastructure, and strengthen the rural health care workforce.
Read the full press release.
Alaska: $160M to Bring Cutting-Edge Technology, Drones Prescription Deliveries, Surgical Robotics & More
This federal investment will help expand access, strengthen the health workforce, improve infrastructure, and advance technology for communities across Alaska.
The Trump Administration announced that a $160 million investment is being delivered to improve health outcomes for Alaskans through the Rural Health Transformation Program. This investment will deliver funding to 142 projects across the state to advance technology, expand coordinated statewide care, and ensure seamless access for patients regardless of their ZIP Code.
Read the full press release.
North Dakota: Critical Funding to Launch the Coordinating & Connecting Care Initiative
This federal investment will help bring high-quality care closer to home by improving coordination for rural North Dakotans.
The Trump Administration announced an additional $1 million, made possible through the federal Rural Health Transformation Program, is being put to work in North Dakota to expand coordinated statewide care and ensure seamless access for patients across the state. The launch of the Coordinating and Connecting Care Initiative will bring together patients, rural health care providers, community-based and volunteer organizations, tribal partners, and other stakeholders to identify gaps, improve communication, and strengthen coordination of health care services across North Dakota.
Read the full press release.
Ohio: $3.15M to Expand Pharmacy Connectivity Throughout Rural Communities
This federal investment will improve interoperability and management of patient health care coordination.
The Trump Administration announced that a $3.15 million investment is being delivered to strengthen pharmacy connectivity and improve care across rural communities in Ohio through the federal Rural Health Transformation Program. The investments will connect independent and retail pharmacies, federally qualified health centers, and outpatient hospital pharmacies across Ohio’s 73 rural counties to improve rural health care providers’ integrated access to critical prescription drug information.
Read the full press release.
Pennsylvania: $35M to Advance Screening Technology, Secure Additional Operating Rooms & Modernize Rural Health Care
This federal investment will help provide technology, equipment, and expanded transportation options for communities across Pennsylvania.
The Trump Administration announced that a $35 million investment is being delivered to improve health outcomes for Pennsylvanians through the federal Rural Health Transformation Program. This investment will expand, upgrade, and modernize screening technology, buying equipment to bring additional operating rooms online and expanding transportation options removing access barriers for patients. This investment in supplies and equipment to help improve care and services advances the Administration’s commitment to strengthen rural health care and ensures Americans can access high-quality no matter their ZIP Code.
Read the full press release.
South Dakota: $90M to Modernize & Improve IT and Interoperability
Federal investment will help fast-track IT modernization, boost cybersecurity, and improve interoperability in rural and underserved communities across South Dakota.
The Trump Administration announced a $90 million investment is being delivered to South Dakota through the federal Rural Health Transformation Program to accelerate digital health modernization, strengthen cybersecurity, and enhance interoperability across rural and underserved communities. This investment will strengthen South Dakota’s health workforce, improve infrastructure, advance technology, and support innovative approaches tailored to the unique health care needs across the state.
Read the full press release.
West Virginia: $4.2M to Expand Medical Transportation & Improve Patient Access to Care
This federal investment will expand medical transportation capacity and help ensure West Virginians have access to high-quality care no matter their ZIP Code.
The Trump Administration announced an additional $4.2 million, made possible through the federal Rural Health Transformation Program, is being put to work in West Virginia to expand patients’ transportation options and remove service barriers.
Read the full press release.
Compliance
Dermatologists: Bill Correctly for Evaluation and Management Services & Minor Surgical Procedures
In a report, the Office of Inspector General found that in 2019 and 2020, approximately 61.5% of Medicare dermatology claims for evaluation and management (E/M) services included a minor surgical procedure on the same day performed by the same dermatologist. These E/M services are generally included in the cost of the minor surgical procedure under Medicare global surgery rules. You should not be paid separately for the E/M component unless a significant, separately identifiable E/M service was performed.
Review the E/M Services (PDF) booklet and learn how to bill correctly:
- Use modifier 25 for a significant and separately identifiable service unrelated to the decision to perform the minor surgical procedure
- Maintain medical record documentation to support the level of service
Claims, Pricers & Codes
Home Health Prospective Payment System Grouper: October Update
Get the October 2026 release (Version 07.2.26 (ZIP)). See the Home Health Prospective Payment System Grouper Software webpage for a summary of changes.
More Information:
- Claims Processing Manual, Chapter 10 (PDF), section 80
- Instruction to your Medicare Administrative Contractor (PDF)
MLN Matters® Articles
Clinical Laboratory Fee Schedule & Clinical Laboratory Improvement Amendments HCPCS Codes, Waived Tests & Reasonable Charge Payments: October 2026 Quarterly Update
Learn about updates (PDF), effective October 1, 2026:
- Annual and quarterly Clinical Laboratory Improvement Amendments edits and new waived test updates
- New and deleted CPT codes
Hospice Payments: FY 2027 Update
Learn about updates (PDF), effective October 1, 2026:
- Payment rates
- Inpatient aggregate caps
- Wage index
ICD-10 & Other Coding Revisions to National Coverage Determinations: January 2027 Update (2 of 2)
Learn about updates (PDF), effective January 1, 2027.
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