Transmittals

Instructions for Retrieving the January 2025 Opioid Treatment Program (OTP) Payment Rates Through the CMS Mainframe Telecommunications System

Removal of Gender References from CMS Publication (Pub.) 100-08, Chapter 10

April 2025 Integrated Outpatient Code Editor (I/OCE) Specifications Version 26.1

April Quarterly Update for 2025 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule

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) 2025

Utilization of KX Modifier Medicare Physician Fee Schedule Payment for Dental Services Inextricably Linked to Covered Medical Services

January 2025 Update of the Ambulatory Surgical Center [ASC] Payment System

Updates to Medicare Benefit Policy Manual and Medicare Claims Processing Manual for Opioid Treatment Programs (OTPs)

Calendar Year (CY) 2025 Home Infusion Therapy (HIT) Payment Rates and Instructions for Retrieving the January 2025 Home Infusion Therapy (HIT) Services Payment Rates Through the CMS Mainframe Telecommunications System

Revision to the Cost Report Acceptability Checklists - This CR Rescinds and Fully Replaces CR 11644.

Updates to Medicare Benefit Policy Manual and Medicare Claims Processing Manual for Opioid Treatment Programs (OTPs)

SUBJECT: Update - Federally Qualified Health Center (FQHC) Participation in and Payment Under the Maryland Primary Care Program (MDPCP) for Healthcare Common Procedure Coding System (HCPCS) Codes 99453 and 99454

Transmittal 1692 issued July 29, 2016, is being rescinded and replaced by Transmittal 13098, dated March 27, 2025, to remove 'Gender' from the background section as required by Executive Order 14168 issued on January 20, 2025, by President Trump, entitled Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government (Defending Women). The U.S. Office of Personnel Management (OPM) provided initial guidance to agencies regarding implementation of Defending Women. HHS considers sex as a biological variable and is committed to ensuring the health and safety of women across the lifespan. All CMS components are expected to comply with Defending Women and OPM guidance by taking prompt actions to end all agency programs that use taxpayer money to promote or reflect gender ideology as defined in Section 2(f) of Defending Women. All other information remains the same.

Update to the National Correct Coding Initiative (NCCI) Procedure-to Procedure (PTP) Edits, version 31.2, Effective July 1, 2025

Transmittal 12965 issued November 14, 2024, is being rescinded and replaced by Transmittal 13112, dated March 21, 2025, to revise the effective and implementation dates to reflect analysis for April, and Implementation in July 2025. This correction also revises the date in business requirement 13739.3. All other information remains the same.

Transmittal 13016 issued December 23, 2024, is being rescinded and replaced by Transmittal 13070, dated March 20, 2025, to remove business requirements 13591.14 and 13591.14.1. All other information remains the same.

Transmittal 12976 issued November 21, 2024, is being rescinded and replaced by Transmittal 13101, dated March 20, 2025, to update the logic for including Pass-Through Amounts for Supply Chain Cost in the "Estimated Total Pass-Through Amounts" field of the online estimating tool when pricing MA (HMO=Y) claims, by revising business requirement 13816.2. All other information remains the same.

Transmittal 12878 issued October 11, 2024, is being rescinded and replaced by Transmittal 13095, dated March 20, 2025, to add business requirement 13775.1.1, instructing that "condition code ML and MN shall not be passed to the BCRC." All other information remains the same.

Transmittal 13054 issued January 16, 2025, is being rescinded and replaced by Transmittal 13132, dated March 20, 2025, to revise Business Requirements (BRs) 13932.1, 13932.4, 13932.4.1, 13932.4.2, and 13932.5. This correction also adds BRs 13932.4.3 and 13932.4.4. All other information remains the same.

International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)—July 2025