MLN Connects Newsletter for June 11, 2026

Date
2026-06-11
Title
In This Edition: Medicare Shared Savings Program | DMEPOS Competitive Bidding | ICD-10 Codes
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News

Compliance

Claims, Pricers & Codes

 

 

News

Medicare Shared Savings Program: Apply by June 23

CMS is now accepting Shared Savings Program applications through the Accountable Care Organization Management System. Apply no later than noon ET on June 23.

More Information:

 

Clinical Diagnostic Laboratories: Report Your Data Through July 31

Are you an independent laboratory, physician office laboratory, or hospital outreach laboratory that meets the definition of an applicable laboratory under the Clinical Laboratory Fee Schedule (CLFS)? If so, you must report your data by July 31, 2026, based on an updated data collection period of January 1 – June 30, 2025, including:

  • Applicable HCPCS codes
  • Associated private payor rates
  • Volume data

How do I report?

  1. Review CLFS Data Collection System resources:
  2. View the applicable HCPCS codes (ZIP)
  3. Use the Data Reporting Template (ZIP); see training video 

More Information:

 

Clinics, Group Practices & Other Suppliers: Use Revised Medicare Enrollment Application Starting August 3

If you don’t use PECOS, use the revised Medicare Enrollment Application for Clinics/Group Practices & Other Suppliers (PDF) (Form CMS-855B) to enroll or update your information. Medicare Administrative Contractors will accept current and revised versions of the form through August 2, 2026. Starting August 3, you must use the revised form.

Form updates:

  • Adds ability for groups to establish, terminate, or change reassignments 
  • Removes physician assistant employer relationship
  • Adds submittal reason: You are solely enrolling in Medicare to participate in Medicaid or another health care program
  • Expands practice location types to include telehealth

Use PECOS to enroll and update your information quicker and easier.

 

DMEPOS Competitive Bidding Phase I Bidder Education: Get Ready for Round 2028

CMS published detailed fact sheets to help bidders understand DMEPOS Competitive Bidding Program rules and prepare for Round 2028. 

More Information:

 

ACCESS Model: Learn How to Support Your Patients with Chronic Conditions

CMS launched a new webpage for primary care providers, health centers, pharmacists, and other referring clinicians explaining how the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model can supplement your care for patients with chronic conditions, including diabetes, high blood pressure, chronic musculoskeletal pain, and depression.

Starting July 5, eligible Original Medicare beneficiaries can sign up with participating ACCESS health care providers to receive technology-supported disease management services at low or no additional cost, such as lifestyle coaching, remote monitoring, wearables, and medication management.

No ACCESS enrollment is required for primary care providers or referring clinicians. The model works within your existing workflows: Refer patients using the ACCESS Directory (launching July 2026), receive structured care updates at key clinical moments, and bill the co-management payment — a Medicare payment with no beneficiary cost-sharing — for coordinating care.

If you have questions, contact ACCESSModelTeam@cms.hhs.gov.

 

Opioid Treatment Programs: CY 2026 Updates

Learn about updates to the Opioid Treatment Program from the CY 2026 Physician Fee Schedule final rule:

 

 

Compliance

DMEPOS: Bill Correctly for Continuous Positive Airway Pressure Devices

In a report, The Office of Inspector General found that continuous positive airway pressure (CPAP) devices had the second highest improper payment amount in the DMEPOS category. Medicare paid claims that didn’t have the required documentation to support the services billed.

Learn about Medicare coverage requirements for CPAP devices and the documentation you need:

 

 

Claims, Pricers & Codes

ICD-10 Codes: FY 2027

Get FY 2027 ICD-10 codes effective for patient discharges and encounters on or after October 1, 2026:

  • ICD-10-CM diagnosis codes
  • ICD-10-PCS procedure codes

 

ICD-10 & Other Coding Revisions to National Coverage Determinations: Manual Updates

CMS updated manuals to reflect Medicare coverage and payment for: 

  • Medicare Claims Processing Manual, Chapter 18 (PDF), section 170.1 - National Coverage Determinations (NCD) 210.10 Screening for Sexually Transmitted Infections (STIs) and High-Intensity Behavioral Counseling to Prevent STIs: Add CPT 87494 (used for combined chlamydia and gonorrhea testing) as a covered code for this policy, effective January 1, 2026
  • Medicare Claims Processing Manual, Chapter 32 (PDF), sections 330.1 and 330.2 - NCD 150.13 Percutaneous Image-Guided Lumbar Decompression for Lumbar Spinal Stenosis: 
    • End date CPT code 0275T, effective December 31, 2025
    • Add CPT code 62330, effective January 1, 2026
    • Add Place of Service 19, effective January 1, 2016

See the instruction to your Medicare Administrative Contractor (PDF). 

 

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