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PC-ACE upgrade and installation instructions

PC-ACE version 7.1 is now available. Follow these instructions to complete the required quarterly upgrades or the full installation after initial enrollment.

MLN Connects Newsletter for July 2, 2026

This edition includes information on hospital OPPS & home health proposed payment rules, GLP-1 bridge, and more.

MLN Connects Newsletter for July 2, 2026

This edition includes information on hospital OPPS & home health proposed payment rules, GLP-1 bridge, and more.

ACCESS model HCPCS G-code allowed amounts

Pricing information is now available for new HCPCS codes payable under Medicare when furnished for the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model.

Process for supplying invoice amount on certain HCPCS codes - avoid rejected claims

The drug codes list and radiopharmaceutical codes lists have been updated.

Hospital off-campus outpatient department reporting requirements

Effective July 6, 2026, outpatient claims with type of bills (TOB) 13X or 14X will be returned to provider (RTP) for reason code 34554 if modifier ER, PO, or PN is billed on all service lines, and…

MLN Connects for June 25, 2026

This edition includes information on the PEPPER relaunch, understanding the telehealth enrollment guide, preventing claim denials for tracheostomy supplies, and more.

MLN Connects for June 25, 2026

This edition includes information on the PEPPER relaunch, understanding the telehealth enrollment guide, preventing claim denials for tracheostomy supplies, and more.

Limited systems availability Thursday, July 2 through Sunday, July 5

There will be Common Working File (CWF) "dark days" Thursday, July 2, through Sunday, July 5, affecting the IVR.

Understanding radiopharmaceutical fee schedule amounts and billing expectations

Read this clarification regarding how radiopharmaceutical payment limits should be interpreted and how providers are expected to bill for these items.