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LCDs and LCAs
by Contractor

PLA Codes

Laboratory Fee Schedule

2020 (July)
2019

Physician Fee Schedule

2020
2019

OPPS Fee Schedule

2020-July
2020-April

ASC Fee Schedule

2020-July
2020-April

APC Codes

2020-July
2020-April

DRG Codes

2020
2019

ASP Drug Pricing Files

July 2020
April 2020


CMS Transmittals



Issue DateTransmittalTitleImplementation Date
2020-08-07 R10278OTN

Create a New Media Preference Indicator Custom Format and New eMedicare Correspondence…

2021-07-06
2020-08-07 R10283OTN

COBOL Version 6.2 Upgrade - Phased Implementation for ViPS Medicare System (VMS) and the Common…

2021-07-05
2020-08-07 R10274CP

Update to Osteoporosis Drug Codes Billable on Home Health Claims

2021-01-04
2020-08-07 R10269BP

Billing for Home Infusion Therapy Services On or After January 1, 2021

2021-01-04
2020-08-07 R10271OTN

Utility to Reprocess Bypassed Common Working File (CWF) Informational Unsolicited Responses (…

2021-04-05
2020-08-07 R10275OTN

Correction to Editing Update for Vaccine Services

2021-01-04
2020-08-07 R10269CP

Billing for Home Infusion Therapy Services On or After January 1, 2021

2021-01-04
2020-08-07 R10281DEMO

Primary Care First (PCF) and Serious Illness Patient (SIP) Models: Part 2: FFS Payments and…

2021-01-04
2020-08-07 R10282DEMO

Telehealth Expansion Benefit Enhancement under the Pennsylvania Rural Health Model (PARHM) -…

2021-01-04
2020-08-06 R10291OTN

Expand Retention of Claims History for Outpatient, Part B, and…

2020-10-05
2020-07-31 R10254CP

Penalty for Delayed Request for Anticipated Payment (RAP)…

2021-01-04
2020-07-31 R10263CP

Influenza Vaccine Payment Allowances - Annual Update for 2020-2021 Season

2020-10-01
2020-07-31 R10261OTN

International Classification of Diseases, 10th Revision (ICD-10…

2020-08-31
2020-07-31 R10260DEMO

Implementation of Nurse Practitioners Certifying Diabetic Shoe…

2021-01-04
2020-07-31 R10248OTN

Update the Combined Common Edits Module (CCEM) for Compatibility…

2021-01-04
2020-07-31 R10250OTN

Update the Combined Common Edits Module (CCEM) for Compatibility…

2021-01-04
2020-07-31 R10243MSP

Updating the Common Working File (CWF) to allow for a Medicare Secondary Payer (MSP) Termination…

2021-01-04
2020-07-31 R10241OTN

Reason Code Updates for the 2020 Annual Therapy Current Procedural Terminology (CPT) Codes in…

2021-01-04
2020-07-31 R10258OTN

Send Electronic Funds Transfer (EFT) Information from Provider Enrollment Chain and Ownership…

2021-01-04
2020-07-31 R10252OTN

Version 6.2 Upgrade - Phased Implementation for Fiscal…

2021-01-04
2020-07-31 R10236CP Update to the IOM Publication (Pub) 100-04, Medicare Claims Processing… 2020-08-31
2020-07-31 R10240OTN

IDR Shared Systems (IDRSS) Reference File Request for the Fiscal…

2021-01-04
2020-07-28 R10239PI

Implementation of Provider Enrollment Provisions in CMS-6058-FC – Phase 1 – Continued Removal/…

2020-08-10
2020-07-27 R10228PI

Updates to Chapters 1, 2, 3, 4, 5, 6, 7, 8, 10, 11, and Exhibits of Publication (Pub.) 100-08

2020-08-27
2020-07-24 R10231OTN

Addition of the QW modifier to Healthcare Common Procedure…

2020-10-05
2020-07-24 R10233CP

Update to the (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 23 - Fee…

2020-06-16
2020-07-24 R10230CP New Waived Tests

2020-10-05
2020-07-21 R10229CP Modify Edits in the Fee for Service (FFS) System When a Beneficiary… 2020-10-05
2020-07-17 R10221CP

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

2020-10-05
2020-07-14 R10222CP

Updates in the Fiscal Intermediary Shared System (FISS)…

2020-10-05
2020-07-15 R10224CP

July 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS)

2020-07-06
2020-07-14 R10223OTN Medicare Appeals System (MAS) Enhanced Web Services for Part A… 2020-08-18
2020-07-10 R10213CP

Influenza Vaccine Payment Allowances - Annual Update for 2020-…

2020-08-03
2020-07-13 R10220FM

Notice of New Interest Rate for Medicare Overpayments and Underpayments -4th Qtr Notification…

2020-07-20
2020-07-10 R10210CP

Update to the Internet Only Manual (IOM) Publication (Pub.) 100-…

2020-08-10
2020-07-10 R10219PI

Moving Chapter 15 (Medicare Enrollment) Manual Instructions in…

2020-06-16
2020-07-10 R10218CP Change to the Payment of Allogeneic Stem Cell Acquisition Services… 2020-10-05
2020-07-10 R10215CP

Changes to the Laboratory National Coverage Determination (NCD)…

2020-10-05
2020-07-10 R10211CP Manual Update to Section 20.7 in Chapter 23 of Publication (Pub) 100-… 2020-08-10
2020-07-10 R10212OTN Reprocessing of Fiscal Year (FY) 2019 and 2020 Inpatient Prospective… 2020-08-25
2020-07-01 R10205OTN

New Point of Origin Code for Transfer From a Designated Disaster…

2020-08-03
2020-07-08 R10217CP

Quarterly Update for Clinical Laboratory Fee Schedule and…

2020-07-06
2020-07-02 R10202CP

Medicare Part A Skilled Nursing Facility (SNF) Prospective…

2020-10-05
2020-07-02 R10203FM The Fiscal Intermediary Shared System (FISS) Submission of Copybook… 2020-10-05
2020-07-02 R10201CP

October 2020 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and…

2020-10-05
2020-07-02 R10207CP

July 2020 Update of the Hospital Outpatient Prospective Payment…

2020-07-06
2020-06-26 R10198CP

Quarterly Update to the End-Stage Renal Disease Prospective…

2020-10-05
2020-06-23 R10196CP Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code… 2020-07-06
2020-06-26 R10197PI Publication (Pub.) 100-08 Chapter 3 Updates to Section 3.2.3.2 (… 2020-07-27
2020-06-19 R10190PI

Revising Chapters 3 and 5 of Publication (Pub.) 100-08, to…

2020-07-01
2020-06-23 R10199NCD

National Coverage Determination (NCD) 160.18 Vagus Nerve Stimulation (VNS)

2020-07-22
2020-06-19 R202SOMA

 State Operations Manual (SOM) Chapter 3,…

2020-07-27
2020-06-19 R10193OTN

International Classification of Diseases, 10th Revision (ICD-10…

2020-03-24
2020-06-19 R10189CP

Quarterly Update to the National Correct Coding Initiative (NCCI…

2020-10-05
2020-06-19 R10188CP July 2020 Update of the Ambulatory Surgical Center (ASC) Payment… 2020-07-06
2020-06-19 R10184PI Updates to Chapters 4, 6, and 8 of Publication (Pub.) 100-08… 2020-07-21
2020-06-19 R10185MPI

Update to Chapter 1 of Publication (Pub.) 100-15

2020-07-21
2020-06-19 R10186CP Updates to Chapter 1, Payer Only Codes in the Medicare Claims… 2020-07-21
2020-06-19 R201SOMA

State Operations Manual (SOM) Chapter 2, The Certification Process

2020-07-27
2020-06-19 R10191CP Quarterly Update to the Long Term Care Hospital (LTCH) Prospective… 2020-07-06
2020-06-15 R10182PI Update to Chapter 10 of Publication (Pub.) 100-08 - Model Letter… 2020-09-16
2020-06-12 R10177CP Annual (2021) Update of the International Classification of Diseases,… 2020-10-05
2020-06-12 R10180CP

Removal of Signature Line from Appeals Page of the Medicare…

2020-10-05
2020-06-10 R10179CP

NCD (20.32) Transcatheter Aortic Valve Replacement (TAVR)…

2020-06-12
2020-06-12 R10172OTN Medicare Appeals System (MAS) Enhanced Web Services for Part A… 2020-07-13
2020-06-12 R10173CP

Internet Only Manual Update, Pub. 100-04, Chapter 11

2020-09-07
2020-06-12 R10174CP Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory… 2020-07-06
2020-06-12 R10171PI Updates to Durable Medical Equipment, Prosthetics, Orthotics &… 2020-07-13
2020-06-12 R10175CP Instructions for Downloading the Medicare ZIP Code Files for October… 2020-10-05
2020-06-12 R10176CP Quarterly Update to Home Health (HH) Grouper… 2020-10-05
2020-06-12 R10178OTN New Point of Origin Code for Transfer From a Designated Disaster… 2020-07-06
2020-06-10 R10179NCD

NCD (20.32) Transcatheter Aortic Valve Replacement (TAVR)…

2020-06-12
2020-06-05 R10165CP July 2020 Integrated Outpatient Code Editor (I/OCE) Specifications… 2020-07-06
2020-06-09 R10170DEMO

Value-Based Insurance Design (VBID) Model – Implementation

2021-01-01
2020-06-05 R10168CP

July Quarterly Update for 2020 Durable Medical Equipment,…

2020-07-06
2020-06-05 R10167CP

Quarterly Update for the Temporary Gap Period of the Durable…

2020-10-05
2020-06-05 R10166CP 2020-07-01 11814
2020-05-22 R10147MSP Update the International Classification of Diseases, Tenth Revision (… 2020-10-05
2020-05-27 R10162OTN

COBOL Version 6.2 Upgrade - Additional Analysis and Phase I…

2020-10-05
2020-05-26 R10161OTN

Therapy Codes Update

2020-06-16
2020-05-22 R10145NCD

National Coverage Determination (NCD) 160.18 Vagus Nerve Stimulation (…

2020-06-23
2020-05-22 R10154CP

National Coverage Determination (NCD) 160.18 Vagus Nerve Stimulation (…

2020-10-05
2020-05-22 R10153CP

October 2020 Healthcare Common Procedure Coding System (HCPCS)…

2020-10-05
R10151CP

Combined Common Edits/Enhancements Modules (CCEM) Code Set…

2020-10-05
2020-05-22 R10045NCD

National Coverage Determination (NCD) 160.18 Vagus Nerve Stimulation (…

2020-06-23
2020-05-22 R10146PI

Implementation of Provider Enrollment Provisions in CMS-6058-FC…

2020-07-24
2020-05-22 R10148CP

Claim Status Category Codes and Claim Status Codes Update

2020-10-05
2020-05-22 R10149CP

Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (…

2020-10-05
2020-05-22 R10150CP

Implement Operating Rules - Phase III Electronic Remittance Advice (…

2020-10-05
2020-05-22 R10160OTN

Summary of Policies in the Calendar Year (CY) 2020 Medicare Physician…

2020-06-12
SE20018 COVID-19 Blanket Swing Bed Waiver for Addressing Barriers to Nursing Home Placement for Hospitalized Individuals
SE20019 Medicare Continues to Modernize Payment Software
SE20017 Medicare Pharmacies and Other Suppliers May Temporarily Enroll as Independent Clinical Diagnostic Laboratories to Help Address COVID-19 Testing
SE20008 Medicare Clarifies Recognition of Interstate License Compacts
SE20016 New and Expanded Flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) During the COVID-19 Public Health Emergency (PHE)
SE20015 New Waivers for Inpatient Prospective Payment System (IPPS) Hospitals, Long-Term Care Hospitals (LTCHs), and Inpatient Rehabilitation Facilities (IRFs) due to Provisions of the CARES Act
SE20012 Supplier Education on Use of Upgrades for Multi-Function Ventilators
SE20011 Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)
SE20010 Ensure Required Patient Assessment Information for Home Health Claims
SE20009 Section 1876 and 1833 Cost Plan Enrollee Access to Care through Original Medicare