News
MLN Matters® Articles
- Clinical Laboratory Fee Schedule & Laboratory Services Subject to Reasonable Charge Payment: October 2025 Update
- DMEPOS Fee Schedule: October 2025 Quarterly Update
Publications & Multimedia
- Evaluation and Management Services — Revised
- Ground Ambulance Data Collection System Codebook — Updated
News
Information for Critical Access Hospitals
The critical access hospital (CAH) bills for facility and professional outpatient services only when physicians or practitioners reassign their billing rights to the CAH.
Learn how CAHs can prevent Fiscal Intermediary Shared System (FISS) reason codes 31006 and 31007 (indicating that providers don’t have a reassignment on file in PECOS) claim denials:
- CAHs must submit the reassignment application through PECOS or the paper Form CMS-855I
- Starting in January 2026, we’ll deny CAH claims for professional services if a reassignment isn’t in PECOS
More Information:
- Information for Critical Access Hospitals (PDF) booklet
- Editing for Duplicate Processing for Practitioner Professional Services and CAH Professional Services (PDF) Medicare Administrative Contractor instruction
- Medicare Part B Overpaid and Beneficiaries Incurred Cost-Share Overcharges of Over $1 Million for the Same Professional Services Office of the Inspector General report
Prostate Cancer: Talk to Your Patients about Screening
Prostate cancer is the second leading cause of cancer deaths in men. Your patients’ Medicare Summary Notices promote prostate cancer screenings. During Prostate Cancer Awareness Month, talk to your patients about screening.
Medicare helps pay for prostate cancer screenings, once every 12 months for men over age 50. Find out when your patient is eligible for screening (PDF). If you need help, contact your eligibility service provider.
More Information:
- Preventive Services webpage
- Prostate cancer screening information for your patients
MLN Matters® Articles
Clinical Laboratory Fee Schedule & Laboratory Services Subject to Reasonable Charge Payment: October 2025 Update
Learn about updates for laboratory billing (PDF) effective October 1, 2025:
- Next reporting period for clinical diagnostic laboratory tests
- New and deleted CPT codes
DMEPOS Fee Schedule: October 2025 Quarterly Update
Learn about updates (PDF) effective October 1, 2025:
- Added and deleted HCPCS codes
- Corrected 2024 deflation factors
Publications & Multimedia
Evaluation and Management Services — Revised
CMS updated billing and coding information (PDF) for:
- Office or outpatient evaluation and management visits
- Critical care services
- Hospital outpatient clinic visits
- Telehealth services
Ground Ambulance Data Collection System Codebook — Updated
CMS updated the Medicare Ground Ambulance Data Collection System (GADCS) Report Year 1 and Year 2 Cohort Analysis Codebook (PDF). We revised column numberings on pages 43–46 to correct minor errors.
This codebook accompanies the Medicare GADCS Report Year 1 and Year 2 Cohort Analysis (PDF) and describes the structure and contents of the analytic file used to conduct the analyses.
More Information:
- Ambulances Services Center webpage
- Medicare GADCS Resources webpage
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The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health & Human Services (HHS).