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ASP Drug Pricing Files

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CMS Transmittals




Issue DateTransmittalTitleImplementation Date
2024-05-16 R12641OTN

Updates to the Recovery Audit Contractor Data Warehouse (RACDW) Suppression Upload File…

2024-10-07
2024-05-16 R12645CP

Update to Pub. 100-04 Medicare Claims Processing Manual, Chapter 23, Section 60.3 Gap-…

2024-06-17
2024-05-15 R12643DEMO

Making Care Primary (MCP) Model Implementation

2024-04-01
2024-05-16 R12642PI

Revisions to Chapter 12 (The Comprehensive Error Rate Testing (CERT) Program) of…

2024-06-17
2024-05-16 R12639PI

Twelfth General Update to Provider Enrollment Instructions in Chapter 10 of CMS…

2024-06-17
2024-05-10 R12635CP

Additional Implementation Edits on Hospice Claims for Hospice Certifying Physician…

2024-10-07
2024-05-10 R12365CP

Additional Implementation Edits on Hospice Claims for Hospice Certifying Physician…

2024-10-07
2024-05-09 R12636OTN

Implement Edits on Hospice Claims

2024-06-03
2024-05-09 R221SOMA

Revisions to the State Operations Manual (SOM) Chapter 10 –Informal Dispute Resolution (…

2024-05-10
2024-05-07 R12625OTN

Fiscal Intermediary Shared System (FISS) User Enhancement Change Request (UECR) -…

2024-04-01
2024-05-09 R12626OTN

International Classification of Diseases, 10th Revision (ICD-10) and Other Coding…

2024-06-10
2024-05-09 R12628CP

Quarterly Update to the End-Stage Renal Disease Prospective Payment System (ESRD PPS)…

2024-07-01
2024-05-09 R12629CP

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - July 2024…

2024-07-01
2024-05-09 R12627CP

Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for Myelodysplastic Syndromes (…

2024-10-07
2024-05-09 R12627NCD

Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for Myelodysplastic Syndromes (…

2024-10-07
2024-05-09 R12631OTN

Fiscal Intermediary Shared System (FISS) - New Process to Create and Use Overridable…

2024-10-07
2024-05-09 R12633PI

Medical Review Policies for Signature Requirements

2024-06-10
2024-05-02 R12599BP

A Social Determinants of Health Risk Assessment in the Annual Wellness Visit Policy Update…

2024-10-07
2024-05-02 R12606CP

Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services…

2024-07-01
2024-05-02 R12600BP

Expand Diabetes Screening and Diabetes Definitions Policy Update in the Calendar Year 2024…

2024-10-07
2024-05-02 R12616OTN

Fiscal Intermediary Shared System (FISS) - User Enhancement Change Request (UECR) - Create…

2024-10-07
2024-05-02 R12617OTN

User Enhancement Change Request (UECR) - Enhance the MCS Desktop Tool (MCSDT) Table…

2024-10-07
2024-05-02 R12608CP

Enhancements to Home Health Consolidated Billing Edits

13550
2024-05-02 R12600CP

Expand Diabetes Screening and Diabetes Definitions Policy Update in the Calendar Year 2024…

2024-10-07
2024-05-02 R12604CP

Internet-Only Manual (IOM) Updates for Split (or Shared) Evaluation and Management Visits…

13592
2024-05-02 R12620DEMO

Primary Care First (PCF) Model: Updated Appendix B - Prohibited Healthcare Common…

2024-10-07
2024-05-02 R12622DEMO

Extension of Payment Period for Pennsylvania Rural Health Model

2024-10-07
2024-05-02 R12618OTN

User Enhancement Change Request (UECR): ViPS Medicare System (VMS) - Increase the Number…

2024-10-07
2024-05-01 R12598DEMO

Create APIs to Support ACO REACH Model - Full Agile Pilot

2024-07-03
2024-05-02 R12601CP

Update to Several Sections of the Internet-only Manual (IOM) Publication (Pub.) 100-04,…

13599
2024-05-02 R12596CP

File Conversions Related to the Spanish Translation of the Healthcare Common Procedure…

2024-07-01
2024-05-02 R12597FM

The Fiscal Intermediary Shared System (FISS) Submission of Copybook Files to the Provider…

2024-07-01
2024-05-02 R12599CP

A Social Determinants of Health Risk Assessment in the Annual Wellness Visit Policy Update…

2024-10-07
2024-04-29 R6P247i

This transmittal updates Chapter 47, Home Health Agency Cost Report, Form CMS-1728-20, by…

N/A
2024-04-26 R12594CP

Outlier Reconciliation and Cost-to-Charge Ratio (CCR) Updates for the Inpatient…

2024-10-01
2024-04-26 R6SPMP

Revisions to Manual for the State Payment of Medicare Premiums

N/A
2024-04-25 R12590NCD

Technical Revision Only to the National Coverage Determination (NCD) Manual, Publication (…

2024-05-27
2024-04-25 R12591PI

Stay of Enrollment

2024-04-01
2024-04-19 R12589BP

Manual Updates for Clarification on Services Under the Medicare Hospice Benefit for Dually…

2024-03-25
2024-04-19 R12588OTN

Fiscal Intermediary Shared System (FISS) - Delete Obsolete Reason Codes - Part 2

2024-04-01
2024-04-19 R220SOMA

Revisions to State Operations Manual (SOM) Appendix A-Hospitals

2024-04-19
2024-04-18 R12586CP

Additional Implementation Edits on Hospice Claims for Hospice Certifying Physician…

2024-10-07
2024-04-16 R496PR1

To update the Medicare Payment Rates for routine SNF-type services by swing-bed hospitals during…

N/A
2024-04-17 R12570CP

CY 2024 Home Infusion Therapy (HIT) Payment Rates and Instructions for Retrieving the…

2024-01-02
2024-04-16 R12585OTN

Report of Hospice Election for Part D (Response File)

2024-04-01
2024-04-15 R12584CP

April Quarterly Update for 2024 Durable Medical Equipment, Prosthetics, Orthotics and…

2024-04-01
2024-04-12 R12579OTN

Fiscal Intermediary Shared System (FISS) - Delete Obsolete Reason Codes - Part 4

2024-07-01
2024-04-12 R219SOMA

Revisions to the State Operations Manual (SOM) Appendix B – Home Health Agencies…

2024-04-12
2024-04-11 R12575CP

Internet Only Manual Updates to Publication 100-04 to Implement Updates to Policy (…

2024-07-12
2024-04-11 R12583FM

Notice of New Interest Rate for Medicare Overpayments and Underpayments -3rd Quarter…

2024-04-17
2024-04-11 R12574OTN

Implementation of the Award for the Jurisdiction 15 (J-15) Part A and Part B Medicare…

2024-05-31
2024-04-11 R12571NCD

National Coverage Determination (NCD) 20.7 Percutaneous Transluminal Angioplasty (PTA) of…

2024-05-13
2024-04-11 R12571CP

National Coverage Determination (NCD) 20.7 Percutaneous Transluminal Angioplasty (PTA) of…

2024-05-13
2024-04-11 R12577CP

Additional Enforcement of Required County Codes on Home Health Claims

2024-10-07
2024-04-09 R12573CP

Manual Update to Section 20.7 in Chapter 23 of Publication (Pub) 100-04

2024-08-10
2024-04-05 R12567DEMO

Making Care Primary (MCP) Model Implementation

2024-04-01
2024-04-04 R12564MSP

Changes to The Electronic Correspondence Referral System (ECRS) Web Includes Updates to…

2024-05-06
2024-04-01 R12356DEMO

Guiding an Improved Dementia Experience (GUIDE) Model Implementation

2024-04-01
2024-03-28 R3P248i

This transmittal updates Chapter 48, Home Office Cost Statement, Form CMS-287-22, to…

2024-03-29
2024-03-28 R12562COM

The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year (FY) 2022…

2024-04-29
2024-03-21 R12553CP

April Quarterly Update for 2024 Durable Medical Equipment, Prosthetics, Orthotics and…

2024-04-01
2024-03-28 R12557CP

Updates to Pub. 100-04 Claims Processing Manual, Chapter 20, Section 181.1 Payment for…

2024-04-29
2024-03-28 R12558CP

Outlier Reconciliation and Cost-to-Charge Ratio (CCR) Updates for the Inpatient…

2024-10-01
2024-03-28 R12559CP

April 2024 Update of the Ambulatory Surgical Center [ASC] Payment System

2024-04-01
2024-03-28 R12560CP

July 2024 Quarterly Update to Healthcare Common Procedure Coding System (HCPCS) Codes Used…

2024-07-01
2024-03-28 R12561CP

Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (…

2024-07-01
2024-03-19 R12549OTN

Fiscal Intermediary Shared System (FISS) User Enhancement Change Request (UECR) -…

2024-04-01
2024-03-21 R12550PI

Eleventh General Update to Provider Enrollment Instructions in Chapter 10 of CMS…

2024-04-21
2024-03-21 R12551CP

April 2024 Integrated Outpatient Code Editor (I/OCE) Specifications Version 25.1

2024-04-01
2024-03-21 R12552CP

April 2024 Update of the Hospital Outpatient Prospective Payment System (OPPS)

2024-04-01
2024-03-14 R12547CP

July 2024 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and…

2024-07-01
2024-03-12 R12539OTN

Implementation to Expand Monetary Amount Fields Related to Billing and Payment to…

2024-04-01
2024-03-14 R12546CP

Update Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.6.1.1 Concerning…

2024-05-15
2024-03-14 R12540CP

Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2024

2024-07-01
2024-03-08 R5P246i

This transmittal updates Chapter 46, Rural Health Clinic (RHC) Cost Report, Form CMS-222-17, by…

N/A
2024-03-08 R218SOMA

Revisions to the State Operating Manual (SOM), Appendix F-Community Mental Health Centers

2024-03-08
2024-03-07 R12534CP

New Waived Tests

2024-04-01
2024-03-08 R12538DEMO

Making Care Primary (MCP) Model Implementation

2024-04-01
2024-03-08 R217SOMA

Revisions to the State Operating Manual (SOM) Chapter 2; Community Mental Health Center (…

2024-03-08
2024-03-07 R12529CP

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-…

2024-07-01
2024-03-07 R12532BP

Update to Pub. 100-02 Medicare Benefit Policy Manual, Chapter 15, Section 110.8…

2024-05-06
2024-03-07 R12533CP

Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04, Chapter 32,…

2024-04-08
2024-03-07 R12536DEMO

Guiding an Improved Dementia Experience (GUIDE) Model Implementation

2024-04-01
2024-03-01 R12525OTN

Patient Driven Payment Model (PDPM) Corrections to Interrupted Stay Edits

2024-04-01
2024-02-29 R4P245i

This transmittal updates Chapter 45, Community Mental Health Center Cost Report, Form CMS-…

N/A
2024-03-01 R12524PI

Stay of Enrollment

2024-06-03
2024-02-22 R12518OTN

Report of Hospice Election for Part D (Response File)

2024-04-01
2024-02-29 R12523CP

Instructions for Downloading the Medicare ZIP Code File for July 2024 Files

2024-07-01
2024-02-29 R22P240i

This transmittal updates Chapter 40, Hospital and Hospital Health Care Complex Cost Report…

N/A
2024-02-29 R7P244i

This transmittal updates Chapter 44, Federally Qualified Health Center (FQHC) Cost Report…

2024-02-29
2024-02-22 R12515PI

Updates of Chapter 4, Chapter 8, and Exhibits in Publication (Pub.) 100-08,…

2024-03-25
2024-02-22 R12516BP

Manual Updates for Clarification on Services Under the Medicare Hospice Benefit…

2024-03-25
2024-02-22 R12517CP

Update of Internet Only Manual (IOM), Pub. 100-04, Chapter 8 - Outpatient ESRD …

2024-03-25
2024-02-22 R12519CP

Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory…

2024-02-22
2024-02-22 R12514PI

Fourth Policy Change Request…

2024-03-25
2024-02-21 R12513OTN

Change Request (CR) to Implement the Medicare Program Final Action: Treatment of…

2024-03-25
2024-02-15 R12511CP

Manual Updates to Chapters 1 and 17 of the Medicare Claims Processing Manual to…

2024-03-18
2024-02-08 R12498CP

Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy…

2024-07-01
2024-02-08 R12506OTN

User Enhancement Change Request (UECR): New Multi-Carrier System (MCS) Inquiry…

2024-04-01
2024-02-08 R12238FM

Manual Update for New Medicare Provider Specialty Codes (E1 and E2) and Payment…

2024-10-02