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ASP Drug Pricing Files

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CMS Transmittals



Issue DateTransmittalTitleImplementation Date
2019-02-15 R4244CP Home Health (HH) Patient-Driven Groupings Model (PDGM) - Split Implementation N/A
2019-02-14 R213NCD National Coverage Determination (NCD) 20.4 Implantable Cardiac Defibrillators (ICDs) 2019-03-26
2019-02-14 R4243CP Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process 2019-04-01
2019-02-15 R4242CP April Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule 2019-04-01
2019-02-15 R2258OTN User CR: MCS - Display Region on Select MCS Screens 2019-07-01
2019-02-15 R2259OTN Modification of the MCS Claims Processing System Logic for Modifier 59, XE, XS, XP, and XU Involving the National Correct Coding Initiative (NCCI) Procedure to Procedure (PTP) Column One and Column Two Codes 2019-07-01
2019-02-15 R4241CP Instructions for Downloading the Medicare ZIP Code Files for July 2019 2019-07-01
2019-02-15 R2260OTN User CR: MCS - Add MSP Confirmed Flag and Cost Avoid to History Screen, IDR, and other Files 2019-07-01
2019-02-13 R2261OTN Direct Mailing Notification to MACs Regarding Addressing the Opioid Crisis 2019-02-28
2019-02-15 R2257OTN User CR: MCS - Health Professional Shortage Area (HPSA) No Pay Remittances Should Not Be Sent for Do Not Forward (DNF) Provider 2019-07-01
2019-02-15 R4238CP Combined Common Edits/Enhancements Modules (CCEM) Code Set Update 2019-07-01
2019-02-15 R4239CP Healthcare Provider Taxonomy Codes (HPTCs) April 2019 Code Set Update N/A
2019-02-12 R863PI Local Coverage Determinations (LCDs) 2019-02-11
2019-02-15 R2256OTN Continued Analysis Calls for Prospective Bundled Payments for Radiation Oncology (RO) Model N/A
2019-02-08 R4237CP Update to the Internet-Only-Manual (IOM) Publication (Pub.) 100-04, Chapter 32, Section 12.1 2019-03-12
2019-02-08 R4234CP Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2019 Update 2019-04-01
2019-02-07 R2255OTN Shared System Enhancement 2018: Rewrite Fiscal Intermediary Shared System (FISS) module FSSB6001, Common Working File (CWF) Unsolicited Response Function 2019-10-07
2019-02-08 R4233CP Update to Publication (Pub.) 100-04 Chapters 4 and 17 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12
2019-02-08 R4236CP Update to Publication (Pub.) 100-04 Chapter 3 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12
2019-02-08 R41COM Update to Publication (Pub.) 100-09 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12
2019-02-08 R4232CP Update to Publication (Pub.) 100-04 Chapter 26 to Provide Language-Only Changes for the New Medicare Card Project 2019-03-12
2019-02-08 R862PI Update to Chapter 15 of Publication (Pub.) 100-08 2019-03-12
2019-02-08 R2251OTN Utilizing the Blank Page on Odd-Numbered Medicare Summary Notices to Promote CMS Priorities 2019-07-01
2019-02-08 R2252OTN Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) 2019-07-01
2019-02-08 R2253OTN Implementation of Additional Contact with Providers in the Event of a Rejected Cost Report Filing 2019-03-12
2019-02-01 R4223CP File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions 2019-04-01
2019-02-01 R2246OTN Expand Narrative File Message Number Range Implementation N/A
2019-02-01 R2245OTN Processing Instructions to Update the Standard Paper Remit (SPR) 2019-07-01
2019-02-01 R2244OTN Multi-Carrier System (MCS) Analysis Change Request (CR) to create Application Program Interfaces (APIs) for Letter Writing 2019-07-01
2019-02-01 R2250OTN User CR: ViPS Medicare System (VMS) changes to the IC4301 - RAC Reopenings and Appeals Tracking Report to Display the Current Appeal Level 2019-07-01
2019-02-01 R2249OTN Analysis on Systems to use Documentation Code References in Additional Documentation Request (ADR) Letters and to Include Non-Medical ADRs for Electronic Medical Documentation Requests (eMDRs) via the Electronic Submission of Medical Documentation (esMD) System 2019-07-01
2019-02-01 R2248OTN Implementation to Exchange the list of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System 2019-07-01
2019-02-01 R2247OTN Analysis Call to Discuss Multi-Carrier System (MCS) Limitation When Quantity Allowed is Greater Than Quantity Billed 2019-07-01
2019-02-01 R4225CP Update to Mammography Editing 2019-07-01
2019-02-01 R4227CP Independent Laboratory Billing of Laboratory Tests for End-Stage Renal Disease (ESRD) Beneficiaries and the Sunset of the CB Modifier 2019-07-02
2019-02-01 R4230CP Implementation of the Medicare Performance Adjustment (MPA) for the Maryland Total Cost of Care (MD TCOC) Model 2019-07-01
2019-02-01 R4228CP Home Health (HH) Patient-Driven Groupings Model (PDGM) - Split Implementation N/A
2019-02-01 R4229CP Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD)—Clarification of Payment Rules and Expansion of International Classification of Diseases Tenth Edition (ICD-10) Diagnosis Codes N/A
2019-02-01 R2243OTN International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) N/A
2019-01-30 R857PI Local Coverage Determinations (LCDs) 2019-01-08
2019-01-29 R2241OTN Enhancing the Verification Process of Common Working File (CWF) Part A Provider Inquiries 2019-04-01
2019-02-01 R256BP Update to Intensive Cardiac Rehabilitation (ICR) Programs 2019-03-19
2019-02-01 R4222CP Update to Intensive Cardiac Rehabilitation (ICR) Programs 2019-03-19
2019-01-25 R2238OTN Reduce/Eliminate Screen-Scraping for Shared Systems by Creating Transaction-based Access to Common Working File (CWF) Beneficiary Data - Analysis and Design 2019-07-01
2019-01-25 R2237OTN Viable Information Processing Systems (ViPS) Medicare Systems (VMS) Changes to Accommodate National Provider Identifier Associations Analysis and Development 2019-07-01
2019-01-25 R2234OTN Utilizing Data from the USPS Secure Destruction Program to Suppress Mailing Medicare Summary Notices (MSNs) to Undeliverable Addresses 2019-04-01
2019-01-25 R2235OTN Revising the Remittance Advice Messaging for the 20-Hour Weekly Minimum for Partial Hospitalization Program (PHP) Services 2019-07-01
2019-01-25 R2233OTN Shared System Enhancement 2018: Automate Health Insurance Master Record (HIMR) Lookup Within Common Working File (CWF) 2019-07-01
2019-01-25 R2231OTN Processing Veterans Administration (VA) Inpatient Claims Exempt from Present on Admission (POA) Reporting 2019-07-01
2019-01-25 R2232OTN Ensuring Organ Acquisition Charges Are Not Included in the Inpatient Prospective Payment System (IPPS) Payment Calculation 2019-07-01
2019-01-25 R4220CP Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process 2019-07-01
2019-01-25 R4219CP Update to Pub. 100-04 Chapter 34 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-26
2019-01-25 R2240OTN User CR: MCS - Print Report Edit/Audit and PJ/PL/PM Set-Up PJ/PL or PL/PM Segments 2019-07-01
2019-01-25 R255BP Updates to Reflect Removal of Functional Reporting Requirements and Therapy Provisions of the Bipartisan Budget Act of 2018 2019-02-26
2019-01-25 R4211CP Update to Publication (Pub.) 100-04 Chapter 11 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-26
2019-01-25 R4213CP April 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files 2019-04-01
2019-01-25 R4214CP Updates to Reflect Removal of Functional Reporting Requirements and Therapy Provisions of the Bipartisan Budget Act of 2018 2019-02-26
2019-01-25 R2230OTN Removal of Quality Programs from the Medicare Physician Fee Schedule (MPFS) Disclosure Report 2019-07-01
2019-01-25 R2229OTN Lock the Claim Term Date on File 41 - Analysis Only 2019-09-01
2019-01-25 R2228OTN Fiscal Intermediary Shared System (FISS) Enhancement of PC Print Billing Software N/A
2019-01-25 R2227OTN New State Code for CA, FL, LA, MI, MS, OH, PA, TN and TX 2019-07-01
2019-01-25 R2226OTN Synchronize the Common Working File (CWF) and Enrollment Data Base (EDB) Entitlement Data N/A
2019-01-24 R2239OTN Targeted Probe and Educate 2017-10-01
2019-01-25 R4210CP Update to Pub. 100-04 Chapter 10 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-26
2019-01-22 R2224OTN ViPS Medicare System (VMS) Prepayment Review File 2019-04-01
2019-01-18 R4209CP Calendar Year (CY) 2019 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule 2019-01-07
2019-01-18 R2223OTN Multi-Carrier System (MCS) Prepayment Review File 2019-04-01
2019-01-17 R4208CP Calendar Year (CY) 2019 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment 2019-01-07
2019-01-18 R2222OTN.zip Update to the Medicare Fee-For-Service (FFS) Companion Guides 2019-03-01
2019-01-18 R2221OTN Fiscal Intermediary Standard System (FISS) Prepayment Review Report 2019-01-01
2019-01-17 R4204CP January 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) 2019-01-07
2019-01-18 R4205CP Update to Pub. 100-04 Chapter 15 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19
2019-01-18 R4203CP Update to Pub. 100-04 Chapter 32 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19
2019-01-18 R4202CP Update to Pub. 100-04 Chapters 8, 20, and 24 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19
2019-01-18 R212NCD Update to Pub. 100-03 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19
2019-01-18 R4201CP Update to Pub. 100-04 Chapter 1 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-19
2019-01-11 R310FM Notice of New Interest Rate for Medicare Overpayments and Underpayments -2nd Qtr Notification for FY 2019 2019-01-17
2019-01-11 R4199CP Clinical Laboratory Fee Schedule – Medicare Travel Allowance Fees for Collection of Specimens 2019-02-12
2019-01-11 R2220OTN Direct Mailing Notification to MACs Regarding Addressing the Opioid Crisis 2019-02-15
2019-01-11 R4200CP 2019 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List 2019-02-12
2019-01-11 R4198CP Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) 2018-04-30
2019-01-11 R2219OTN Shared System Enhancement 2018: Enhance Common Working File (CWF) Internal Testing Facility (ITF) Response Records 2019-04-01
2019-01-11 R4197CP Chapter 30 Revisions in Publication (Pub.) 100-04, Medicare Claims Processing Manual 2019-04-15
2019-01-11 R4194CP Update to Publication (Pub.) 100-04 Chapter 25 to Provide Language-Only Changes for the New Medicare Card Project 2019-02-12
2019-01-11 R4195CP New Waived Tests 2019-04-01
2019-01-11 R4192CP Quarterly Update for the Temporary Gap Period of the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) - April 2019 2019-04-01
2019-01-11 R4193CP Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 25.1 Effective April 1, 2019 2019-04-01
2019-01-11 R854PI Local Coverage Determinations (LCDs) 2019-01-08
2019-01-04 R853PI Updates to the Appeals Prioritization Process 2019-02-05
2019-01-03 R2218OTN ViPS Medicare System (VMS) Prepayment Review File 2019-04-01
2018-12-31 R4191CP January 2019 Update of the Ambulatory Surgical Center (ASC) Payment System 2019-01-07
2018-12-31 R4190CP Home Health Rural Add-on Payments Based on County of Residence 2019-01-07
2018-12-21 R4186CP January 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) 2019-01-07
2018-12-31 R4189CP Updates to Immunosuppressive Guidance 2019-04-03
2018-12-28 R2217OTN Multi-Carrier System (MCS) Prepayment Review File 2019-04-01
2018-12-28 R4188CP Medicare Claims Processing Manual Chapter 23 - Fee Schedule Administration and Coding Requirements 2019-01-30
2018-12-28 R2216OTN Clarification of Part B Recovery Audit Contractor (RAC) Appeals Case File Sharing Process 2019-07-01
2018-12-28 R2215OTN Analysis of the Combined Common Edits/Enhancements Module (CCEM) and MSSQL and Oracle Relational Data Base Management Systems 2017-07-01
2018-12-28 R4187CP Ensuring Only the Active Billing Hospice Can Submit a Revocation 2019-07-01
2018-12-21 R4185CP January 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.0 2019-01-07