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2018 ICD-10 Diagnosis Code Set Loaded     


10/01/2017 NCD Edits Loaded     


2017-D October DME Fee Schedule     


2017-A PEN Fee Schedule-no changes for rest of 2017     


2017-D October ASC Fee Schedule Updated     


2018-A October APC Fee Schedule Updated     


October 2017 ASP Drug Pricing Updated     


Q1 2018 CCI Edits Loaded     


Q1 2018 MUE Edits Loaded     


LCD Database Current Through 02/20/2018     

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CMS Transmittals



IMPORTANT NOTICE: Updated W-9 for new address 3/1/18 available here.

Issue DateTransmittalTitleImplementation Date
2018-02-23 R3982CP Update to the Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) for Calendar Year (CY) 2018 - Recurring File Update 2018-04-02
2018-02-23 R771PI Clarification of Instructions Regarding the Intensive Level of Rehabilitation Therapy Services Requirements 2018-03-23
2018-02-23 R773PI Form CMS-855O Processing Guide 2018-03-23
2018-02-16 R2035OTN Targeted Probe and Educate Metrics Deliverables Update and Glossary 2018-03-19
2018-02-16 R3977CP Healthcare Provider Taxonomy Codes (HPTCs) April 2018 Code Set Update 2018-07-02
2018-02-16 R3978CP Common Edits and Enhancements Modules (CEM) Code Set Update 2018-07-02
2018-02-16 R2033OTN ICD-10 and Other Coding Revisions to National Coverage Determinations (NCDs) N/A
2018-02-16 R2032OTN Provider Enrollment, Chain, and Ownership System (PECOS) Extract Changes for Multi-Carrier System (MCS) - Analysis Only 2018-07-02
2018-02-16 R4PR242 Provider Reimbursement Manual Part 2, Provider Cost Reporting Forms and Instructions, Chapter 42, Form CMS-265-11 N/A
2018-02-16 R2031OTN Modifications to the Implementation of the Paperwork (PWK) Segment of the Electronic Submission of Medical Documentation (esMD) System 2018-07-02
2018-02-16 R3980CP Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update 2018-07-02
2018-02-16 R3976CP Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2018 Update 2018-04-02
2018-02-16 R2034OTN Identifying and Eliminating Discrepancies in Shared System Enrollment Data and Provider Enrollment Chain and Ownership System (PECOS) Data 2018-07-01
2017-10-27 R3895CP Revised and New Modifiers for Oxygen Flow Rate 2018-04-02
2018-02-09 R3975CP Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits 2018-04-02
2018-02-08 R3974CP Diagnosis Code Update for Add-on Payments for Blood Clotting Factor Administered to Hemophilia Inpatients 2018-07-02
2018-02-08 R768PI Post-Payment Review Timeliness Requirements 2018-04-01
2018-02-08 R3972CP Update to the Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) for Calendar Year (CY) 2018 - Recurring File Update 2018-04-02
2018-02-08 R3973CP Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment 2018-04-02
2018-02-02 R3963CP Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 24.1, Effective April 1, 2018 2018-04-01
2018-02-02 R3971CP E/M Service Documentation Provided by Students (Manual Update) 2018-03-05
2018-02-02 R3970CP Removal of Contractor Reporting Requirements for the Physician Scarcity Area (PSA), the Health Professional Shortage Area Surgical Incentive Payment Program (HSIP) and the Primary Care Payment Incentive Program (PCIP) Quarterly Reports 2018-07-02
2018-02-02 R3969CP Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) 2018-07-02
2018-02-02 R298FM Removal of Contractor Reporting Requirements for the Physician Scarcity Area (PSA), the Health Professional Shortage Area Surgical Incentive Payment Program (HSIP) and the Primary Care Payment Incentive Program (PCIP) Quarterly Reports 2018-07-02
2018-02-02 R204NCD Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD 2018-07-02
2018-02-02 R3965CP Reinstating the Qualified Medicare Beneficiary Indicator in the Medicare Fee-For-Service Claims Processing System from CR 9911 2018-07-02
2018-02-02 R2029OTN Implementation of Automating First Claim Review in Serial Claims for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) N/A
2018-02-02 R3962CP Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process N/A
2018-02-02 R2028OTN Shared System Enhancement 2014: Implementation of Fiscal Intermediary Shared System (FISS) Obsolete Financial Reports - Phase 3 2018-07-02
2018-02-02 R3966CP Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - April 2018 Update 2018-04-02
2018-07-02 R3968CP Consumer Friendly Spanish Descriptors for the Current Procedural Terminology (CPT) / Level 1 Healthcare Common Procedure Coding System (HCPCS) Codes and a Correction to the Part A Spanish Medicare Summary Notices (MSNs) 2018-07-02
2018-02-02 R2030OTN Shared System Enhancement 2014: Implementation of Fiscal Intermediary Shared System (FISS) Obsolete Core Reports - Phase 3 2018-07-02
2018-02-02 R191DEMO Update to CR9341 Oncology Care Model (OCM) Restricted Care Management Code List 2018-07-02
2018-02-02 R3MPI Update to the Medicaid Program Integrity Manual (PIM) 2018-04-03
2018-02-02 R241BP New “K” Code for Therapeutic Shoe Inserts 2018-04-02
2018-02-02 R766PI Comprehensive Error Rate Testing (CERT) Updates to Chapter 12 of Pub. 100-08 2018-03-02
2018-02-02 R2025OTN Shared System Enhancement 2014: Implementation of Fiscal Intermediary Shared System (FISS) Obsolete On-Request Jobs - Phase 1 N/A
2018-02-02 R2026OTN Part B Detail Line Expansion - Multi-Carrier System (MCS) Phase 8 N/A
2018-02-02 R3961CP Editing Update for Mammography Services 2018-07-02
2018-01-30 R13P240 By reissuing transmittal 12 as transmittal 13, in order to revise the effective date from cost reporting periods ending on or after August 31, 2017 to cost reporting periods ending on or after September 30, 2017. No other revisions are made in this transmittal. N/A
2018-01-26 R177SOMA Revisions to State Operations Manual (SOM) Appendix G, Guidance for Surveyors: Rural Health Clinics 2018-01-26
2018-01-26 R2015OTN Updates to the Common Working File (CWF) to Allow Entry Code 9 Durable Medical Equipment (DME) Claims to Process Correctly 2018-01-26
2018-01-26 R2014OTN Identifying Prior Hospice Days When Calculating Hospice Routine Home Care Payments After a Transfer 2018-07-02
2018-01-26 R2013OTN Global Surgical Days for Critical Access Hospital (CAH) Method II 2018-01-26
2018-01-26 R2012OTN Analysis of Reject Responses for Prior Authorization/Pre-Claim Review Requests (PA/PCR) via the Electronic Submission of Medical Documentation (esMD) System and Usage of Standardized Review Reason Codes and Statements 2018-07-02
2018-01-26 R2011OTN Shared System Enhancement 2015: Identify Inactive Medicare Demonstration Codes 46, 48, and 49 within the Fiscal Intermediary Shared System (FISS) 2018-07-02
2018-01-26 R2010OTN Analysis Only: Procedures to Handle Foreign (non US) Addresses 2018-07-02
2018-01-26 R2016OTN Part B Detail Line Expansion - VMS 2018-01-26
2018-01-26 R2017OTN Updates to Common Working File (CWF) Edits for Acute Kidney Injury (AKI) Claims 2018-07-02
2018-01-26 R2018OTN Shared System Enhancement 2014: Implementation of Fiscal Intermediary Shared System (FISS) Obsolete Core Reports - Phase 2 2018-07-02
2018-01-26 R2019OTN Redesign of Flu Vaccines in Fiscal Intermediary Shared System (FISS) N/A
2018-01-26 R2021OTN Shared System Enhancement 2014: Implementation of Fiscal Intermediary Shared System (FISS) Obsolete Financial Reports - Phase 2 2018-07-02
2018-01-25 R2022OTN Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process 2018-02-18
2018-01-24 R2008OTN Shared System Enhancement 2015: Identify Inactive Medicare Demonstration Projects Within the Common Working File (CWF) 2018-07-02
2018-01-19 R3953CP Revisions to the Claims Processing for Grandfathered Oxygen Claims that Span Competitive Bidding Rounds 2018-07-02
2018-01-19 R2006OTN Monthly Status Report (MSR) Excel Data Template Updates and Implementation of MAC/CMS Data Exchange (MDX) Portal System 2018-02-20
2018-01-18 R2005OTN ICD-10 and Other Coding Revisions to National Coverage Determinations (NCDs) N/A
2018-01-19 R240BP Internet Only Manual (IOM) Update to Pub. 100-02, Chapter 11 - End Stage Renal Disease (ESRD), Section 100 2018-02-20
2018-01-12 R476PR1 Medicare Provider Reimbursement Manual Part 1, Chapter 9, Compensation of Owners 2018-01-12
2018-01-12 R297FM Notice of New Interest Rate for Medicare Overpayments and Underpayments -2nd Qtr Notification for FY 2018 2018-01-19
2018-01-12 R3950CP 2018 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List 2018-02-13
2018-01-12 R3949CP Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits 2018-04-02
2018-01-12 R2000OTN MCS Proof of Concept to Convert Existing MCSDT Window to Utilize API Technology 2018-07-02
2018-01-12 R477PR1 Medicare Provider Reimbursement Manual Part 1, Chapter 14, Reasonable Cost of Therapy and Other Services Furnished by Outside Suppliers 2018-01-12
2018-01-10 R1999OTN Implementation of the Transitional Drug Add-On Payment Adjustment 2018-01-02
2018-01-09 R239BP Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Medicare Benefit Policy Manual Chapter 13 Update 2018-01-22
2017-12-08 R296FM Cessation of MAC Validation of Recovery Audit Program New Issues 2018-01-02
2018-01-08 R765PI Medicare Diabetes Prevention Program (MDPP) Enrollment Process 2018-01-19
2018-01-05 R3948CP Ensuring Correct Processing of Home Health Disaster Related Claims and Claims for Denial 2018-07-02
2018-01-05 R3947CP April 2018 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files 2018-04-02
2018-01-05 R3946CP File Conversions Related to the Spanish Translation of the Healthcare Common Procedure Coding System (HCPCS) Descriptions 2018-04-02
2018-01-04 R1998OTN HIGLAS Enhancement Required for Implementation of Overpayment based Denials 2018-04-02
2018-01-05 R3945CP New Waived Tests 2018-04-02
2018-01-05 R1997OTN Enhancement to the Recovery Audit Contractor (RAC) Mass Adjustment Input File 2018-07-02
2018-01-05 R1996OTN Analyze Common Working File (CWF) System and Identify Layouts with Minimum FILLER Areas Available 2018-04-02
2017-12-01 R3931CP CY 2018 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule 2018-01-02
2017-12-13 R1985OTN Analysis Only- Medicare Reporting on the Return of Self-Identified Overpayments 2018-07-02
2017-12-08 R3932CP Special Requirements for Immunosuppressive Drugs 2018-03-09
2017-12-08 R111GI Update to Medicare Deductible, Coinsurance and Premium Rates for 2018 2018-01-02
2017-12-28 R1994OTN Suppression of the Standard Paper Remittance Advice (SPR) in 45 Days if Also Receiving Electronic Remittance Advice (ERA) 2018-01-02
2017-12-29 R762PI Update to Chapter 15 of Pub. 100-08 2018-01-29
2017-12-29 R1993OTN Analyze the Common Working File (CWF) System and Identify Customer Information Control System (CICS) Screens Requiring Expansion 2018-04-02
2017-12-29 R176SOMA Revisions to State Operations Manual (SOM) Appendix A – Survey Protocol, Regulations and Interpretive Guidelines for Hospitals 2017-12-29
2017-12-29 R1991OTN Method of Cost Settlement for Inpatient Services for Rural Hospitals Participating Under the Rural Community Hospital Demonstration 2018-01-29
2017-12-22 R3943CP Correction to Prevent Payment on Inpatient Information Only Claims for Beneficiaries Enrolled in Medicare Advantage Plans 2018-04-02
2017-12-21 R1990OTN Suppression of the Standard Paper Remittance Advice (SPR) in 45 Days if Also Receiving Electronic Remittance Advice (ERA) 2018-01-01
2017-12-22 R3939CP January 2018 Update of the Ambulatory Surgical Center (ASC) Payment System 2018-01-02
2017-12-22 R3938CP Summary of Policies in the Calendar Year (CY) 2018 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, and CT Modifier Reduction List 2018-01-02
2017-12-22 R3937CP Changes to the Laboratory National Coverage Determination (NCD) Edit Software for April 2018 2018-04-02
2017-12-22 R3942CP Clinical Laboratory Fee Schedule – Medicare Travel Allowance Fees for Collection of Specimens 2018-01-22
2017-12-22 R175SOMA Revisions to State Operations Manual (SOM) Appendix J, Part II – Interpretive Guidelines – Responsibilities of Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) 2017-12-22
2017-12-22 R3941CP January 2018 Update of the Hospital Outpatient Prospective Payment System (OPPS) 2018-01-02
2017-12-22 R3940CP January 2018 Integrated Outpatient Code Editor (I/OCE) Specifications Version 19.0 2018-01-02
2018-12-21 R3936CP Updated Editing of Always Therapy Services - MCS 2018-01-02
2017-12-20 R1989OTN Fiscal Intermediary Shared Systems (FISS) Enhancements to the Mass Adjustment of Process Recovery Audit Contractor (RAC) Claims 2018-04-02
2017-12-19 R1988OTN National Provider Identification Crosswalk System (NPICS) Retirement Analysis Only - Engage Shared Systems Maintainers (SSMs) and Medicare Administrative Contractors (MACs) in Meetings and Correspondence Related to the NPICS Retirement with the Integrated Data Repository (IDR) Team 2018-01-02
2017-12-19 R3935CP Instructions for Retrieving the 2018 Pricing and HCPCS Data Files through CMS' Mainframe Telecommunications Systems 2018-01-02
2017-12-08 R3933CP Revisions to the Home Health Pricer to Support Value-Based Purchasing and Payment Standardization 2018-01-02
2017-12-15 R1987OTN Archiving National Provider Identifier Crosswalk System (NPICS) System Logic in the Durable Medical Equipment (DME) Claims Processing System 2018-07-02
2017-12-15 R3934CP Calendar Year (CY) 2018 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment 2018-01-02