Medicare News


Medicare News includes information for health care professionals about Medicare programs, policies and initiatives. Use these resources to stay up-to-date about current and planned Medicare changes.

Palmetto GBA maintains links to recently released and revised Centers of Medicare & Medicaid Services (CMS) MLN® articles. All MLN Matters articles will continue to be available on the CMS MLN Matters website. MLN Connects® will contain Medicare related messages from CMS. These messages ensure planned, coordinated messages are delivered timely about Medicare related topics.





Medicare News Articles


National Coverage Determination (NCD) 20.19 Ambulatory Blood Pressure Monitoring (ABPM)Ensure Required Patient Assessment Information for Home Health ClaimsJanuary 2020 Quarterly Release Temporary HoldTop Time-Saving Tools for Palmetto GBA ProvidersAugust 2019 JM Home Health and Hospice Medicare AdvisoryOctober 2020 JM Home Health and Hospice Medicare AdvisoryManual Updates Related to the Hospice Election Statement and the Implementation of the Election Statement AddendumUpdate to the Home Health Grouper for New Diagnosis Codes for Vaping Related Disorder and COVID-19New Codes for Therapist Assistants Providing Maintenance Programs in the Home Health SettingRecent and Upcoming Improvements in Hospice Billing and Claims ProcessingMarch 2020 JM Home Health and Hospice Medicare AdvisoryDecember 2020 JM Home Health and Hospice Medicare AdvisoryInfluenza and Pneumonia Vaccinations in the Home Health or Hospice SettingNovember 2020 JM Home Health and Hospice Medicare AdvisoryAugust 2020 JM Home Health and Hospice Medicare AdvisoryInternet Only Manual Update, Pub. 100-04, Chapter 11 - This CR Rescinds and Fully Replaces CR 11807July 2020 JM Home Health and Hospice Medicare AdvisoryQuarterly Update to Home Health (HH) GrouperUpdate to Osteoporosis Drug Codes Billable on Home Health ClaimsHome Health Agencies (HHAs) Urged to Establish Access to the Internet Quality Improvement and Evaluation System (iQIES) By December 23, 2019What New Home Health Agencies (HHAs) Need to Know About Being Placed in a Provisional Period of Enhanced OversightApril 2020 JM Home Health and Hospice Medicare AdvisoryJuly 2019 JM Home Health and Hospice Medicare AdvisoryJune 2020 JM Home Health and Hospice Medicare AdvisoryDecember 2019 JM Home Health and Hospice Medicare AdvisoryRedesign of Hospice Periods - Additional RequirementsSeptember 2020 JM Home Health and Hospice Medicare AdvisoryMay 2020 JM Home Health and Hospice Medicare AdvisoryVBID Hospice Benefit Component Information Now AvailableAdvance Directives and the Home Health Plan of CareUpdate to Hospice Payment Rates, Hospice Cap, Hospice Wage Index and Hospice Pricer for FY 2021Quarterly Update to Home Health (HH) GrouperPatient Discharge Status and Patient Overlap StatusDirect Mailing Notification to Hospice Providers Regarding the Hospice Benefit Component, Value-Based Insurance Design (VBID) Model, for Participating Medicare Advantage Organizations (MAOs)Internet Quality Improvement and Evaluation System (iQIES) Known IssuesFebruary 2020 JM Home Health and Hospice Medicare AdvisoryPeriodic Interim Payments (PIP) and Pass-Through Payment One-Day DelayAdditional Documentation Requests (ADRs) Can Be ConfusingJanuary 2021 Integrated Outpatient Code Editor (I/OCE) Specifications Version 22.0CMS Provider Minute Videos for Part A and Part B Providers and DMEPOS SuppliersApril 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS)Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2021How to Use the Medicare Coverage DatabaseReading An Institutional Remittance Advice (RA)How often does CMS update the Medicare Revalidation List due date information?Did You Know Putting Condition Code D9 on Your Claim Will Cause it to Suspend?Medicare Cost Report E-Filing (MCReF)Claim Status Category and Claim Status Codes UpdatesMLN Connects Special Edition - Friday, December 18, 2020MLN Connects for Thursday, February 11, 2021April 2020 Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesApril Quarterly Update for 2020 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee ScheduleImportant Credit Balance (CMS-838) Report InformationRemittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print UpdateRemittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print UpdatePayments and Payment Adjustments under the Patient-Driven Groupings ModelAlpha-Numeric HCPCSCY 2021 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee ScheduleMLN Connects Special Edition - January 7, 2021MLN Connects Special Edition - Friday, December 18, 2020: COVID-19: Add-on Payment for New Treatments.MLN Connects for Thursday, January 28, 2021Manual Update to Pub. 100-04, Chapter 38, to Remove Identification of Items or Services Related to the 2010 Oil Spill in the Gulf of Mexico SectionApril 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesRequest for Accelerated Payment InstructionImplement 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) COREMedicare Advantage (MA) Plans Adherence to Local and National Coverage Determination InquiriesMedicare Coverable Services for Integrative and Nonpharmacological Chronic Pain ManagementReduce Risk of Opioid Overdose Deaths by Avoiding and Reducing Co-Prescribing BenzodiazepinesOverview of the Patient Driven Groupings ModelOctober Quarterly Update for 2020 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee ScheduleJuly 2020 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesRemittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print UpdateQuarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - October 2020 UpdateAccepting Payment from Patients with a Medicare Set-Aside ArrangementProvider Responsibility2021 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) UpdateMLN Connects Special Edition - Monday, December 14, 2020Add Dates of Service (DOS) for Pneumococcal Pneumonia Vaccination (PPV) Health Care Procedure Code System (HCPCS) Codes (90670, 90732), and Remove Next Eligible Dates for PPV HCPCSImplement 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) COREImplement 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) CORECredit Balance Reports: Submission Tips Meeting CMS StandardsSubmit Medical Record Documentation via esMDClaim Status Category and Claim Status Codes UpdateMLN Connects for Thursday, February 4, 20212021 Annual Update to the Therapy Code ListJanuary 2021 Update of the Hospital Outpatient Prospective Payment System (OPPS)Medicare Clarifies Recognition of Interstate License CompactsDrug Claims Rejected in ErrorNew Physician Specialty Code for Micrographic Dermatologic Surgery (MDS) and Adult Congenital Heart Disease (ACHD) and a New Supplier Specialty Code for Home Infusion Therapy ServicesQuarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2020 UpdateSummary of Policies in the Calendar Year (CY) 2021 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 ListMLN Connects Special Edition - Thursday, December 10, 2020Implement 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) CORETherapy Codes UpdateQuarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - July 2020 UpdateMLN Connects for Thursday, March 4, 2021Identify a ProviderDrug Claims Rejected in ErrorMLN Connects Special Edition - Monday, December 28, 2020Reminder on Billing Requirements Implemented for non-OPPS ProvidersValue-Based Insurance Design (VBID) Model - Implementation of the Hospice Benefit ComponentPlease Do Not Email Protected Health Information (PHI)MLN Connects for Thursday, January 7, 2021January 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesMLN Connects for Thursday, January 21, 2021October 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS)MLN Connects for Thursday, February 25, 2021July 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS)Local Coverage Determinations (LCDs)October 2020 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesRemittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print UpdateClaim Status Category and Claim Status Codes UpdateA Prescriber's Guide to the New Medicare Part D Opioid Overutilization Policies for 2019MLN Connects for Thursday, January 14, 2021MLN Connects for Thursday, February 18, 2021MLN Connects Special Edition - Wednesday, December 9, 2020Review of Hospital Compliance with Medicare's Transfer Policy with the Resumption of Home Health Services and the Use of Condition Codes (A-04-18-04067)Medicare Advantage Plan Directory (CMS website)Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - July 2020 UpdateMedicare Plans to Modernize Payment Grouping and Code Editor SoftwareJuly Quarterly Update for 2020 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee ScheduleMLN Connects for Thursday, December 17, 2020Billing for Services when Medicare is a Secondary Payer2021 Annual Update of Per-Beneficiary Threshold AmountsEntering Beneficiary Information: eServices Eligibility Inquiry vs. Claim SubmissionNew Medicare Card: HICN Claims Reject January 1, 2020Palmetto GBA to Consolidate Twitter AccountsOctober 2020 Release Dark Days for the Common Working File (CWF) HostsPalmetto GBA Achieved a Capability Maturity Model Integration (CMMI) Maturity Level 4 RatingLivanta's Memorandum of Agreement (MOA) for Healthcare ProvidersImportant Tax Information - 1099 FormsWays to Connect to Palmetto GBABankruptcyLooking for Medicare Coverage Information?Fraud Alert: Genetic Testing ScamUnsolicited Fax or Email InquiryNew Requirements Added for Changing and Resetting Passwords in Direct Data Entry (DDE)Reminder of Advance Beneficiary Notice of Noncoverage (ABN) Renewal2021 Provider Contact Center Training and Holiday Closure ScheduleHow To Recognize an SMRC AuditContact Information on Medicare NoticesAre You Receiving Email updates from Palmetto GBA?2020 Medical Review (MR) Hot Topic Targeted Probe and Educate (TPE) Teleconference ScheduleProvider Compliance Tips for Nebulizers and Related Drugs Fact Sheet - RevisedRemittance Advice Resources and FAQs (CMS Product)Home Health ReferralsDurable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Part APromoting Interoperability (PI) ProgramsMLN Connects Special Edition - Wednesday, March 10, 2021MLN Connects for Thursday, December 10, 2020April 2021 Update of the Hospital Outpatient Prospective Payment System (OPPS)Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2021 UpdateRemittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) & PC Print UpdateApril Quarterly Update for 2021 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee ScheduleSave Time with eTicketHome Health Payment CorrectionsMLN Connects Special Edition - Tuesday, December 22, 2020Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)MLN Connects for Wednesday, December 23, 2020Summary of Policies in the Calendar Year (CY) 2020 Medicare Physician Fee Schedule (MPFS) Public Health Emergency (PHE) Interim Final RulesMedicare Diabetes Prevention Program Suppliers: Separate Medicare EnrollmentCertifying Patients for the Medicare Home Health BenefitCMS Open Payments Data WebsiteNew Medicare Beneficiary Identifier (MBI) Get It, Use ItDiscontinuation of Common Working File (CWF) Eligibility Access for New Direct Data Entry (DDE) ID RequestsCorrection to Period Sequence Edits on Home Health ClaimsThe Role of Therapy under the Home Health Patient-Driven Groupings Model (PDGM)Provider Self Service ApplicationsMLN Connects for Thursday, April 1, 2021MLN Connects Special Edition - Tuesday, March 30, 2021MLN Connects Special Edition - Monday, March 15, 2021MLN Connects for Thursday, March 25, 2021MLN Connects for Thursday, March 18, 2021MLN Connects for Thursday, March 11, 2021New Provider Enrollment Administrative Action AuthoritiesUpdate to the Manual for Telephone Services, Physician Assistant (PA) Supervision, and Medical Record Documentation for Part B ServicesRepayment of COVID-19 Accelerated and Advance Payments Began on March 30, 2021Therapy Claims: Reprocessing Dates of Service from January 1 through February 15MLN Connects newsletter for Thursday, April 8, 2021Penalty for Delayed Request for Anticipated Payment (RAP) Submission - ImplementationMLN Connects Special Edition - Thursday, April 8, 2021If You've Contacted Us Recently, We Would Love to Hear About Your Experience!MLN Connects Special Edition - Wednesday, April 14, 2021eTicket Enables Providers to Save Time with Every CallMLN Connects for Friday, April 16, 2021ePass is Available to Ease the Burden of Repeated Authentication When Calling Palmetto GBA's Provider Contact CenterAssisted Suicide Funding Restriction Act of 1997 (P.L. 105-12)Palmetto GBA Education Events