Palmetto GBA maintains links recent released/revised CMS MLN Matters articles. All MLN Matters articles will continue to be available on the CMS MLN Matters website.

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Fiscal Year (FY) 2020 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Changes Open in New Window10/09/2019
October 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) Open in New Window10/09/2019
Ambulance Inflation Factor for Calendar Year (CY) 2020 and Productivity Adjustment Open in New Window10/07/2019
Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) Open in New Window10/07/2019
Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Updates for Fiscal Year (FY) 2020 Open in New Window10/03/2019
International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) - January 2020 Update Open in New Window10/02/2019
Provider Enrollment Rebuttal Process Open in New Window10/02/2019
Changes to the Laboratory National Coverage Determination (NCD) Edit Software for January 2020 Open in New Window10/01/2019
January 2020 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files Open in New Window10/01/2019
October 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files Open in New Window09/19/2019
Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - October 2019 Update Open in New Window09/19/2019
Billing for Hospital Part B Inpatient Services Open in New Window09/16/2019
2019-2020 Influenza (Flu) Resources for Health Care Professionals Open in New Window09/10/2019
Additional Instructions to Hospitals on the Election of a Medicare Supplemental Security Income (SSI) Component of the Disproportionate Share (DSH) Payment Adjustment for Cost Reports that Involve SSI Ratios for Fiscal Year (FY) 2004 and Earlier, or SSI Ratios for Hospital Cost-Reporting Periods for Patient Discharges Occurring Before October 1, 2004 Open in New Window09/09/2019
Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations Open in New Window09/06/2019
Additional Instructions to Hospitals on the Election of a Medicare-Supplemental Security Income (SSI) Component of the Disproportionate Share (DSH) Payment Adjustment for Cost Reports that Involve SSI Ratios for Fiscal Year (FY) 2004 and Earlier, or SSI Ratios for Hospital Cost-Reporting Periods for Patient Discharges Occurring Before October 1, 2004 Open in New Window09/06/2019
2020 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments Open in New Window09/05/2019
Hurricane Dorian and Medicare Disaster Related States of Georgia and South Carolina Claims Open in New Window09/05/2019
2020 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update Open in New Window09/04/2019
Annual Clotting Factor Furnishing Fee Update 2020 Open in New Window09/04/2019
Influenza Vaccine Payment Allowances - Annual Update for 2019-2020 Season Open in New Window09/04/2019
October 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.3 Open in New Window09/04/2019
October Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule Open in New Window09/04/2019
Implementation to Exchange the List of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System Open in New Window08/28/2019
Claim Status Category and Claim Status Codes Update Open in New Window08/26/2019
Healthcare Provider Taxonomy Codes (HPTCs) October 2019 Code set Update Open in New Window08/26/2019
Implement 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 Healthcare (CAQH) CORE Open in New Window08/26/2019
New Documentation Requirements for Filing Medicare Cost Reports Open in New Window08/26/2019
Medicare Coverable Services for Integrative and Nonpharmacological Chronic Pain Management Open in New Window08/21/2019
New Medicare Beneficiary Identifier (MBI) Get It, Use It Open in New Window08/21/2019
Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2020 Open in New Window08/19/2019
Manual Update to Sections 1.2 and 10.2.1 in Chapter 18 of the Medicare Claims Processing Manual Open in New Window08/19/2019
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - October 2019 Update Open in New Window08/19/2019
Bypassing Payment Window Edits for Donor Post-Kidney Transplant Complication Services Open in New Window08/12/2019
Display PARHM Claim Payment Amounts Open in New Window08/12/2019
Instructions for Use of Informational Remittance Advice Remark Code Alert on Laboratory Service Remittance Advices Open in New Window08/06/2019
Medicare Shared Savings Program (Shared Savings Program) Skilled Nursing Facility (SNF) Affiliates' Requirement to Include Demonstration Code 77 on SNF 3-Day Rule Waiver Claims Open in New Window08/06/2019
Modification to the National Coordination of Benefits Agreement (COBA) Crossover Process Open in New Window08/06/2019
October Quarterly Update to 2019 Annual Update of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement Open in New Window08/06/2019
Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment Open in New Window08/06/2019
Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging - Educational and Operations Testing Period - Claims Processing Requirements Open in New Window07/29/2019
Documentation of Medical Necessity of the Home Visit; and Physician Management Associated with Superficial Radiation Treatment Open in New Window07/26/2019
Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2019 Open in New Window07/16/2019
Update to Coverage of Intravenous Immune Globulin for Treatment of Primary Immune Deficiency Diseases in the Home Open in New Window07/16/2019
Emergency Medical Treatment and Labor Act (EMTALA) and the Born-Alive Infant Protection Act Open in New Window07/11/2019
Medicare Plans to Modernize Payment Grouping and Code Editor Software Open in New Window07/11/2019
Reduce Risk of Opioid Overdose Deaths by Avoiding and Reducing Co-Prescribing Benzodiazepines Open in New Window07/11/2019
Medicare Summary Notice (MSN) Changes to Assist Beneficiaries Enrolled in the Qualified Medicare Beneficiary (QMB) Program Open in New Window07/10/2019
July 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.2 Open in New Window07/05/2019
Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment Open in New Window07/05/2019
July Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule Open in New Window07/03/2019
Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2020 Open in New Window07/03/2019
Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - July 2019 Update Open in New Window06/27/2019
Implement 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 Healthcare (CAQH) CORE Open in New Window06/11/2019
July 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) Open in New Window06/03/2019
Documentation of Medical Necessity of the Home Visit, and Physician Management Associated with Superficial Radiation Treatment Open in New Window05/31/2019
Chimeric Antigen Receptor (CAR) T-Cell Therapy Revenue Code and HCPCS Setup Revisions Open in New Window05/30/2019
Additional Processing Instructions to Update the Standard Paper Remit (SPR) Open in New Window05/23/2019
Claim Status Category and Claim Status Codes Update Open in New Window05/21/2019
Proper Use of Modifier 59 Open in New Window05/21/2019
Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update Open in New Window05/21/2019
International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) Open in New Window05/09/2019
Documentation of Evaluation and Management Services of Teaching Physicians Open in New Window05/06/2019
Medicare Physician Fee Schedule Database File Record Layout Open in New Window05/06/2019
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - July 2019 Update Open in New Window05/06/2019
Re-implementation of the AMCC Lab Panel Claims Payment System Logic Open in New Window05/06/2019
Systems Changes to Allow IPPS-Excluded Hospitals to Operate IPPS-Excluded Units Open in New Window05/06/2019
Updating Fiscal Intermediary Shared System (FISS) for Pricing Drugs at Different Rates Depending on Provider Type Open in New Window05/06/2019
Quarterly Update to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Open in New Window05/01/2019
Implementation to Exchange the List of Enrollment in Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System Open in New Window04/22/2019
National Coverage Determination (NCD90.2): Next Generation Sequencing (NGS) Open in New Window04/18/2019
Pub. 100-04, Chapter 29 - Appeals of Claims Decisions - Revisions Open in New Window04/16/2019
Correction of the Fiscal Year (FY) 2019 Inpatient Prospective Payment System (IPPS) Pricer Open in New Window04/01/2019
The Supplemental Security Income/Medicare Beneficiary Data for Fiscal Year 2017 for Inpatient Prospective Payment System Hospitals, Inpatient Rehabilitation Facilities, and Long Term Care Hospitals Open in New Window04/01/2019
Evaluation and Management (E/M) When Performed with Superficial Radiation Treatment Open in New Window03/29/2019
Changes to the Laboratory National Coverage Determination (NCD) Edit Software for July 2019 Open in New Window03/28/2019
July 2019 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files Open in New Window03/27/2019
Billing for Hospital Part B Inpatient Services Open in New Window03/25/2019
Update to the Payment for Grandfathered Tribal Federally Qualified Health Centers (FQHCs) for Calendar Year (CY) 2019 Open in New Window03/25/2019
April 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) Open in New Window03/20/2019
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2019 Update Open in New Window03/20/2019
April 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.1 Open in New Window03/18/2019
Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update Open in New Window03/18/2019
Next Generation Accountable Care Organization (NGACO) Model Post Discharge Home Visit HCPCS Open in New Window03/11/2019
Revising the Remittance Advice Messaging for the 20-Hour Weekly Minimum for Partial Hospitalization Program Services Open in New Window03/04/2019
NCD 20.4 Implantable Cardiac Defibrillators (ICDs) Open in New Window02/27/2019
Ensuring Organ Acquisition Charges Are Not Included in the Inpatient Prospective Payment System (IPPS) Payment Calculation Open in New Window02/25/2019
April Quarterly Update for 2019 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule Open in New Window02/20/2019
Healthcare Provider Taxonomy Codes (HPTCs) April 2019 Code Set Update Open in New Window02/20/2019
Local Coverage Determinations (LCDs) Open in New Window02/19/2019
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 Open in New Window02/08/2019
International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) Open in New Window02/07/2019
Update to Intensive Cardiac Rehabilitation (ICR) Programs Open in New Window02/07/2019
Common Working File (CWF) Provider Queries National Provider Identifier (NPI) Verification Open in New Window02/06/2019
Independent Laboratory Billing of Laboratory Tests for End-Stage Renal Disease (ESRD) Beneficiaries and the Sunset of the CB Modifier Open in New Window02/05/2019
Processing Instructions to Update the Standard Paper Remit (SPR) Open in New Window02/05/2019
April 2019 Quarterly ASP Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files Open in New Window01/29/2019
Processing Veterans Administration (VA) Inpatient Claims Exempt from Present on Admission (POA) Reporting Open in New Window01/29/2019
Updates to Reflect Removal of Functional Reporting Requirements and Therapy Provisions of the Bipartisan Budget Act of 2018 Open in New Window01/29/2019
Total Knee Arthroplasty (TKA) Removal from the Medicare Inpatient-Only (IPO) List and Application of the 2-Midnight Rule Open in New Window01/25/2019
Communication Technology Based Services and Payment for Rural Health Clinic (RHCs) and Federally Qualified Health Centers (FQHCs) Open in New Window01/24/2019
Calendar Year (CY) 2019 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule Open in New Window01/23/2019
January 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) Open in New Window01/23/2019
Calendar Year (CY) 2019 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment Open in New Window01/22/2019
New Electronic System for Provider Reimbursement Review Board Appeals Open in New Window01/22/2019
New Medicare Webpage on Patient Driven Payment Model Open in New Window01/15/2019
Clinical Laboratory Fee Schedule - Medicare Travel Allowance Fees for Collection of Specimens Open in New Window01/14/2019
Medicare Claims Processing Manual, Chapter 30 Revisions Open in New Window01/14/2019
Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN) Open in New Window01/14/2019
Payment for Implanted Prosthetic Devices for Medicare Part B Inpatients Open in New Window01/10/2019
International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) Open in New Window01/08/2019
Home Health Rural Add-on Payments Based on County of Residence Open in New Window01/03/2019
Updates to Immunosuppressive Guidance Open in New Window01/03/2019
January 2019 Integrated Outpatient Code Editor (I/OCE) Specifications Version 20.0 Open in New Window12/27/2018
New Search Features Added to Fiscal Intermediary Shared System (FISS)/Direct Data Entry (DDE) Open in New Window12/27/2018
Guidance for Medicare Administrative Contractors (MACs) Processing Beneficiary and Family Centered Care (BFCC) Quality Improvement Organizations (QIO) Two-Midnight (2MN) Short Stay Review (SSR) Determinations Open in New Window12/26/2018
Inpatient Rehabilitation Facility (IRF) Medical Review Changes Open in New Window12/21/2018
New Physician Specialty Code for Undersea and Hyperbaric Medicine Open in New Window12/21/2018
Implementation of Changes in the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Payment for Dialysis Furnished for Acute Kidney Injury (AKI) in ESRD Facilities for Calendar Year (CY) 2019 Open in New Window12/17/2018
Next Generation Accountable Care Organization (ACO) Model 2019 Benefit Enhancement Open in New Window12/17/2018
Quarterly Influenza Virus Vaccine Code Update - January 2019 Open in New Window12/17/2018
Updates to the Inpatient Psychiatric Facility Benefit Policy Manual Open in New Window12/17/2018
Hurricane Florence and Medicare Disaster Related North Carolina, South Carolina, and the Commonwealth of Virginia Claims Open in New Window12/13/2018
Hurricane Michael and Medicare Disaster Related Florida and Georgia Claims Open in New Window12/13/2018
Revision of Definition of the Physician Supervision of Diagnostic Procedures, Clarification of DSMT Telehealth Services, and Establishing a Modifier for Expanding the Use of Telehealth for Individuals with Stroke Open in New Window12/11/2018
Annual Update to the Per-Beneficiary Therapy Amounts Open in New Window12/05/2018
Ambulance Inflation Factor for Calendar Year 2019 and Productivity Adjustment Open in New Window12/04/2018
Summary of Policies in the Calendar Year (CY) 2019 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 List Open in New Window12/04/2018
New Modifier for Expanding the Use of Telehealth for Individuals with Stroke Open in New Window11/28/2018
Update to the Federally Qualified Health Center (FQHC) Prospective Payment System (PPS) for Calendar Year (CY) 2019 - Recurring File Update Open in New Window11/26/2018
Quarterly Update of HCPCS Codes Used for Home Health Consolidated Billing Enforcemen Open in New Window11/20/2018
Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update Open in New Window11/20/2018
Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2019 Open in New Window11/19/2018
Update to Rural Health Clinic (RHC) All Inclusive Rate (AIR) Payment Limit for Calendar Year (CY) 2019 Open in New Window11/19/2018
User CR: Fiscal Intermediary Shared System (FISS) - Implementation of the Molecular Diagnostic Services (MolDX) Open in New Window11/14/2018
International Classification of Diseases, Tenth Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) Open in New Window11/12/2018
Certifying Patients for the Medicare Home Health Benefit Open in New Window11/07/2018
Implementation of Healthcare Common Procedure Coding System (HCPCS) Code J3591 and Additional Changes for End Stage Renal Disease (ESRD) Claims Open in New Window11/07/2018
Medicare Cost Report E-Filing (MCReF) Open in New Window11/07/2018
Update to Medicare Deductible, Coinsurance and Premium Rates for 2019 Open in New Window11/07/2018
Hospital and Critical Access Hospital (CAH) Swing-Bed Manual Revisions Open in New Window11/05/2018
A Prescriber's Guide to the New Medicare Part D Opioid Overutilization Policies for 2019 Open in New Window11/02/2018
Correction to Common Working File (CWF) Informational Unsolicited Response (IUR) 7272 for Intervening Stay Open in New Window10/29/2018
Incomplete Colonoscopies Billed with Modifier 53 for Critical Access Hospital (CAH) Method II Providers Open in New Window10/29/2018
Update to Common Working File (CWF) Edit of Medicare Advantage (MA) Enrollees' Inpatient Claims from Approved Teaching Hospitals Billed for Indirect Medical Education Open in New Window10/29/2018
Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations Open in New Window10/15/2018
Fiscal Year (FY) 2019 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) PPS Changes Open in New Window10/12/2018
Ensuring Occurrence Code 22 is Billed Correctly on Skilled Nursing Facility Inpatient Claims Open in New Window10/08/2018
Intensity-Modulated Radiation Therapy (IMRT) Planning Services Editing Open in New Window09/12/2018
Annual Clotting Factor Furnishing Fee Update 2019 Open in New Window09/10/2018
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