CMS Medicare Learning Network (MLN)


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.

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CMS Medicare Learning Network (MLN) Articles


National Coverage Determination (NCD) 20.19 Ambulatory Blood Pressure Monitoring (ABPM)Ensure Required Patient Assessment Information for Home Health ClaimsManual 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 ProcessingInternet Only Manual Update, Pub. 100-04, Chapter 11 - This CR Rescinds and Fully Replaces CR 11807Quarterly 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 OversightRedesign of Hospice Periods - Additional RequirementsVBID Hospice Benefit Component Information Now AvailableUpdate to Hospice Payment Rates, Hospice Cap, Hospice Wage Index and Hospice Pricer for FY 2021Quarterly Update to Home Health (HH) GrouperDirect Mailing Notification to Hospice Providers Regarding the Hospice Benefit Component, Value-Based Insurance Design (VBID) Model, for Participating Medicare Advantage Organizations (MAOs)January 2021 Integrated Outpatient Code Editor (I/OCE) Specifications Version 22.0April 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS)Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2021Medicare 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 ScheduleRemittance 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 ModelCY 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 FilesImplement 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 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 Arrangement2021 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) COREClaim 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, 2021MLN 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 ComponentMLN 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)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 AmountsMLN 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 ScheduleHome 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 RulesCertifying Patients for the Medicare Home Health BenefitNew Medicare Beneficiary Identifier (MBI) Get It, Use ItCorrection to Period Sequence Edits on Home Health ClaimsThe Role of Therapy under the Home Health Patient-Driven Groupings Model (PDGM)MLN 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, 2021MLN Connects Special Edition - Wednesday, April 14, 2021MLN Connects for Friday, April 16, 2021Assisted Suicide Funding Restriction Act of 1997 (P.L. 105-12)MLN Connects Special Edition: Tuesday, April 20, 2021MLN Connects for Thursday, April 22, 2021MLN Connects Special Edition: Tuesday, April 28, 2021July 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesMLN Connects for Thursday, April 29, 2021MLN Connects for Thursday, May 6, 2021MLN Connects Special Edition: Tuesday, May 11, 2021