Thursday, June 5, 2025
News
- 2023 Doctors & Clinicians Preview Period Open Until June 25
- Hospital Price Transparency: Respond to Accuracy & Completeness RFI by July 21
- Medicare & Veteran Affairs: Adjustments for Duplicate Claims Start Next Month
- Join an Accountable Care Organization
Claims, Pricers & Codes
- RHC & FQHC Care Coordination Services: HCPCS Code G0511 Deadline Extended to September 30
- Medical Education: Submit No-Pay Bills for Programs of All-Inclusive Care for the Elderly
MLN Matters® Articles
Publications & Multimedia
News
2023 Doctors & Clinicians Preview Period Open Until June 25
The Doctors and Clinicians Preview Period is open until Wednesday, June 25 at 8 pm ET. Securely preview your 2023 Quality Payment Program performance information before it appears on clinician and group profile pages on the Medicare.gov compare tool and in the Provider Data Catalog.
For more information, visit the Care Compare: Doctors and Clinicians Initiative webpage.
Hospital Price Transparency: Respond to Accuracy & Completeness RFI by July 21
CMS issued a Request for Information (RFI) seeking public input on whether and how we can improve hospital price transparency (HPT) compliance and enforcement processes to ensure that the hospital pricing data in the machine-readable file is accurate and complete. This RFI relates to the President’s Executive Order 14221 to ensure compliance with the transparent reporting of complete, accurate, and meaningful HPT data.
More Information:
Respond by 11:59 pm ET on July 21, 2025.
Medicare & Veteran Affairs: Adjustments for Duplicate Claims Start Next Month
CMS entered into a computer matching agreement to identify claims paid by both Medicare and the Department of Veteran Affairs (VA). Starting next month, we’ll take action to recover any duplicate payments.
You must bill services authorized by the VA to the VA.
More Information:
- Adjustment of Medicare Claims Where Veteran Affairs Also Made Payment (PDF) MLN Matters article
- Medicare Secondary Payer Manual, Chapter 7 (PDF), section 20.5.2
Join an Accountable Care Organization
Medicare providers: To participate in an Accountable Care Organization (ACO) for performance year 2026, work with an ACO to join their participant list. ACOs must submit their lists to CMS by August 1, 2025, by:
- Noon ET for the Medicare Shared Savings Program
- 11:59 pm ET for the ACO REACH Model
Participant taxpayer identification numbers cannot overlap multiple ACO participant lists. Resolve any overlaps by September 8.
More Information:
- Application Types & Timeline webpage
- Email questions to SharedSavingsProgram@cms.hhs.gov or ACOREACH@cms.hhs.gov
Claims, Pricers & Codes
RHC & FQHC Care Coordination Services: HCPCS Code G0511 Deadline Extended to September 30
Starting January 1, 2025, CMS requires Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) to report individual CPT and HCPCS base and add-on codes for care coordination service instead of reporting HCPCS code G0511. We allowed additional time for you to make this change to your billing systems and continue billing G0511 until July 1, 2025. Now, the deadline is extended to September 30. After this date, you will no longer be able to bill for HCPCS code G0511.
More Information:
- RHC Center webpage, including list of CY 2025 payment rates for care coordination
- FQHC Center webpage, including list of CY 2025 payment rates for care coordination
- CY 2025 Physician Fee Schedule final rule
Medical Education: Submit No-Pay Bills for Programs of All-Inclusive Care for the Elderly
Programs of All-Inclusive Care for the Elderly (PACE) is excluded from the Inpatient Prospective Payment System for direct graduate medical and nursing and allied health education for Medicare Advantage enrollees. See the Medicare Claims Processing Manual, Chapter 3 (PDF), section 20.8 for information on how to submit no-pay bills.
The PACE organization accepts the capitation payment amounts as payment in full. See PACE, Chapter 13 (PDF) section 10.1.
MLN Matters® Articles
ESRD & Acute Kidney Injury Dialysis: CY 2025 Updates — Revised
CMS revised this article to provide the updated post-Transitional Drug Add-on Payment Adjustment amounts (PDF).
Publications & Multimedia
Quality in Focus Interactive Video Series: 4 New Videos to Enhance Quality of Care
Check out the CMS Quality in Focus interactive video series on the Quality, Safety & Education Portal Training Catalog webpage under the “Quality in Focus (QIF)” tab. These 10–15 minute videos are tailored to specific provider types and aim to enhance the quality of care for individuals enrolled in Medicare and Medicaid by addressing and reducing the deficiencies cited most during CMS surveys, like infection control and accident prevention.
We recently added 4 new videos to address common deficiencies:
- Long Term Care (LTC): Infection Prevention and Control
- LTC: Food Safety Requirements
- Clinical Laboratory Improvement Amendments: Successful Participation in a Proficiency Testing Program
- Critical Access Hospitals: Patient Care Policies
They’ll help you learn how to:
- Understand surveyor evaluation criteria
- Recognize deficiencies
- Incorporate solutions into your facility’s standards of care
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