CMS Medicare Learning Network (MLN)

Published 07/01/2017

We encourage you to visit the Medicare Learning Network® (MLN), your source for official CMS Medicare fee-for-service (FFS) provider educational information. Get quick access to MLN Matters national provider education articles that help you understand new or revised Medicare policy and other educational products.

  • MLN Matters Articles: These articles explain national Medicare policy in an easy-to-understand format
  • MLN Publications: These educational resources explain topics such as coding, preventive services, and provider compliance
  • MLN Calls & Webcasts: These events, presented by CMS experts, cover changes to the Medicare program.
  • MLN Provider Compliance: Learn how to avoid common errors with these educational resources

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Guidance on Coding and Billing Date of Service on Professional ClaimsProvider Enrollment - Unlicensed ResidentsProper Coding for Specimen Validity Testing Billed in Combination with Drug TestingInternet Only Manual Update to Pub. 100-04, Chapter 16, Section 60.1.2 and Pub. 100-04, Chapter 26, Section 10.4, Item 19Pre-Diabetes Services: Referring Patients to the Medicare Diabetes Prevention ProgramCurrent Medicare Coverage of Diabetes SuppliesFoot Care Coverage GuidelinesIncorrect Billing of HCPCS L8679 - Implantable Neurostimulator, Pulse Generator, Any TypeProper Use of Modifier 59Medically Unlikely Edits (MUE) and Bilateral Surgical ProceduresProhibition Billing Dually Eligible Individuals Enrolled in the Qualified Medicare Beneficiary (QMB) ProgramSection 1876 and 1833 Cost Plan Enrollee Access to Care through Original MedicareNext Generation Accountable Care Organization - ImplementationMedicare Part B Home Infusion Therapy Services With The Use of Durable Medical EquipmentOverview of the Patient Driven Groupings ModelReview of Opioid Use during the Initial Preventive Physical Examination (IPPE) and Annual Wellness Visit (AWV)NCD 20.4 Implantable Cardiac Defibrillators (ICDs)Billing for Services when Medicare is a Secondary PayerUse of the AT modifier for Chiropractic Billing (New Information Along with Information in MM3449)Medicare Coverable Services for Integrative and Nonpharmacological Chronic Pain ManagementA Prescriber's Guide to the New Medicare Part D Opioid Overutilization Policies for 2019FAQs on the 3-Day Payment Window for Services Provided to Outpatients Who Later Are Admitted as InpatientsAccepting Payment from Patients with a Medicare Set-Aside ArrangementReduce Risk of Opioid Overdose Deaths by Avoiding and Reducing Co-Prescribing BenzodiazepinesAppropriate Use Criteria (AUC) for Advanced Diagnostic Imaging - Approval of Using the K3 Segment for Institutional ClaimsProvider Compliance Tips for Polysomnography (Sleep Studies) - RevisedPayments and Payment Adjustments under the Patient-Driven Groupings ModelLocal Coverage Determinations (LCDs)Reminder on Billing Requirements Implemented for non-OPPS ProvidersMedicare Pharmacies and Other Suppliers May Temporarily Enroll as Independent Clinical Diagnostic Laboratories to Help Address COVID-19 TestingEducational Resources to Assist Chiropractors with Medicare BillingQuarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2021 UpdateQuarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge PaymentCertifying Patients for the Medicare Home Health BenefitNew Medicare Beneficiary Identifier (MBI) Get It, Use ItRepayment of COVID-19 Accelerated and Advance Payments Began on March 30, 2021Assisted Suicide Funding Restriction Act of 1997 (P.L. 105-12)MLN Connects for Thursday, May 13, 2021MLN Connects Special Edition - Thursday, July 1, 2021October Quarterly Update to 2021 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) EnforcementJuly 2021 Update of the Ambulatory Surgical Center [ASC] Payment SystemJuly Quarterly Update for 2021 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee ScheduleSection 50 in Chapter 30 of Publication (Pub.) 100-04 Manual UpdatesImplement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Health Care (CAQH) COREQuarterly Update to the National Correct Coding Initiative [NCCI] Procedure-to-Procedure [PTP] Edits, Version 27.3, Effective October 1, 2021October 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesMLN Connects Special Edition: Monday, August 2, 2021Medicare Coverage for Chiropractic Services: Medical Record Documentation Requirements for Initial and Subsequent VisitsInternet Only Manual Updates to Publication (Pub.) 100-02 to Implement Updates to Policy and Correct Errors and Omissions (Inpatient Rehabilitation Facility (IRF))New Waived TestsInternet Only Manual Updates to Pub. 100-01, 100-02, and 100-04 to Implement Consolidated Appropriations Act Changes and Correct Errors and Omissions (SNF)Changes to the Laboratory National Coverage Determination [NCD] Edit Software for October 2021Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Health Care (CAQH) COREMedicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)Annual Clotting Factor Furnishing Fee Update 20222022 Annual Update for the Health Professional Shortage Area (HPSA) Bonus PaymentsQuarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - October 2021 UpdateQuarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services Subject to Reasonable Charge PaymentClaims Processing Instructions for National Coverage Determination 20.33 - Transcatheter Edge-to-Edge Repair (TEER) for Mitral Valve RegurgitationOctober 2021 Update of the Ambulatory Surgical Center (ASC) Payment SystemInfluenza Vaccine Payment Allowances - Annual Update for 2021-2022 SeasonOctober Quarterly Update for 2021 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee ScheduleInternational Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) - January 2022Medicare Clarifies Recognition of Interstate License Compacts PathwaysTraining Medicare Patients on Use of Home Glucose Monitors and Related Billing InformationQuarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 28.0, Effective January 1, 2022January 2022 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesChanges to the Laboratory National Coverage Determination (NCD) Edit Software for January 2022Claim Status Category and Claim Status Codes UpdateNational Coverage Determination (NCD 110.24): Chimeric Antigen Receptor (CAR) T-cell TherapyInternational Classification of Diseases, 10th Revision (ICD10) and Other Coding Revisions to National Coverage Determinations (NCDs) - April 2022 (CR 2 of 2)MLN Connects for Thursday, November 4, 2021Modifications/Improvements to Value-Based Insurance Design (VBID) Model - ImplementationNew Waived Tests2022 Annual Update of Per-Beneficiary Threshold AmountsMedicare Part B CLFS: Revised Information for Laboratories on Collecting and Reporting Data for the Private Payor Rate-Based Payment System2022 Annual Update to the Therapy Code ListRemittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print UpdateNational Expansion of the Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization ModelSkilled Nursing Care and Skilled Therapy Services to Maintain Function or Prevent or Slow Decline: ReminderReduced Payment for Physical Therapy and Occupational Therapy Services Furnished in Whole or In Part by a Physical Therapist Assistant or an Occupational Therapy AssistantUpdate to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year (CY) 2022Incorporation of Recent Provider Enrollment Regulatory Changes into Chapter 10 of CMS Publication (Pub.) 100-08Calendar Year 2022 Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee ScheduleSummary of Policies in the Calendar Year (CY) 2022 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services ListMedicare Diabetes Prevention Program (MDPP) Service Period Change from 2 Years to 1 YearAddition of the QW Modifier to Healthcare Common Procedure Coding System (HCPCS) Code 86328Transvenous (Catheter) Pulmonary Embolectomy National Coverage Determination (NCD) Section 240.6January 2022 Update of the Ambulatory Surgical Center (ASC) Payment SystemChanges to the Laboratory National Coverage Determination (NCD) Edit Software for April 2022Skin Substitute CodesCalendar Year (CY) 2022 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge PaymentInternational Classification of Diseases, 10th Revision (ICD10) and Other Coding Revisions to National Coverage Determinations (NCDs) - April 2022 (CR 1 of 2)Standard Elements for DMEPOS Order, and Master List of DMEPOS Items Potentially Subject to a Face-to-Face Encounter and Written Orders Prior to Delivery and, or Prior Authorization RequirementsCY2022 Telehealth Update Medicare Physician Fee ScheduleHealthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) EditsClinical Laboratory Fee Schedule - Medicare Travel Allowance Fees for Collection of SpecimensQuarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services Subject to Reasonable Charge PaymentNational Coverage Determination (NCD) 270.3 Blood-Derived Products for Chronic, Non-Healing WoundsQuarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2022 UpdateInternet-Only Manual Updates for Critical Care Evaluation and Management ServicesInternet-Only Manual Updates (IOM) for Critical Care, Split/ Shared Evaluation and Management Visits, Teaching Physicians, and Physician AssistantsApril Quarterly Update for 2022 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee ScheduleApril 2022 Update of the Ambulatory Surgical Center (ASC) Payment SystemRemittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print UpdateClaims Processing Instructions for the New Pneumococcal 15-valent Conjugate Vaccine Code 90671 and Pneumococcal 20-valent Conjugate Vaccine Code 90677MLN Connects Special Edition: Wednesday, March 30, 2022Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting and Reporting Data for the Private Payor Rate-Based Payment SystemMLN Connects for Thursday, March 31, 2022MLN Connects Special Edition: Thursday, March 31, 2022MLN Connects Special Edition: Monday April 4, 2022MLN Connects Special Edition: Wednesday, April 6, 2022MLN Connects for Thursday April 7, 2022MLN Connects Special Edition: Thursday, April 8, 2022Unsolicited Voluntary RefundsMLN Connects Special Edition: Monday, April 11, 2022MLN Connects for Thursday, April 14, 2021MLN Connects Special Edition for Monday, April 18, 2022Update to Publication 100-04, Chapter 18 and Publication 100-02, Chapter 15, Section to Add Data Regarding Novel Coronavirus (COVID-19) and its Administration to Current Claims Processing Requirements and Other General UpdatesMLN Connects for Thursday, April 21, 2022New Waived TestsMLN Connects for Thursday, April 28, 2022CWF Editing - National Coverage Determination (NCD) 270.3 Blood-Derived Products for Chronic, Non-Healing WoundsInternational Classification of Diseases, 10th Revision (ICD10) and Other Coding Revisions to National Coverage Determinations (NCDs) - July 2022Changes to Beneficiary Coinsurance for Additional Procedures Furnished During the Same Clinical Encounter As Certain Colorectal Cancer Screening TestsUpdate of Internet Only Manual (IOM), Pub. 100-04, Chapter 15 - AmbulanceCalendar Year 2023 Modifications/Improvements to Value-Based Insurance Design (VBID) Model - ImplementationNational Coverage Determination (NCD) 210.14 Reconsideration - Screening for Lung Cancer with Low Dose Computed Tomography (LDCT)MLN Connects for Thursday, May 5, 2022Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and Laboratory Services Subject to Reasonable Charge PaymentMLN Connects for Thursday, May 12, 2022MLN Connects for Thursday, May 19, 2022MLN Connects for Thursday, May 26, 2022New/Modifications to the Place of Service (POS) Codes for TelehealthAn Omnibus CR Covering: (1) Removal of Two National Coverage Determination (NCDs), (2) Updates to the Medical Nutrition Therapy (MNT) Policy, and (3) Updates to the Pulmonary Rehabilitation (PR), Cardiac Rehabilitation (CR), and Intensive Cardiac Rehabilitation (ICR) Conditions of CoverageUpdate to 'J' Drug Code List for Billing Home Infusion Therapy (HIT) ServicesMLN Connects for Thursday, June 2, 2022Revisions to Medicare Part B Coverage of Pneumococcal Vaccinations for the Medicare Benefit Policy Manual Chapter 15, Section 50.4.4.2MLN Connects for Thursday, June 9, 2022Comprehensive Error Rate Testing Program Report: Sample Reduced for Reporting Year 2023July Quarterly Update for 2022 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee ScheduleJuly 2022 Update of the Ambulatory Surgical Center (ASC) Payment SystemMLN Connects for Thursday, June 16, 2022MLN Connects Special Edition: Tuesday June 21, 2022International Classification of Diseases, 10th Revision (ICD10) and Other Coding Revisions to National Coverage Determinations (NCDs)-October 2022International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) - July 2021MLN Connects for Thursday, June 23, 2022Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update