Medicare/CMSMedium ImpactBilling Codes

2026-02-05 - Hospitals: Submit Data for OPPS Drug Acquisition Cost Survey by March 31

Published February 5, 2026Effective January 1, 2026

AI Summary

The MLN Connects newsletter for February 5, 2026 announces multiple billing updates including a March 31 deadline for hospitals to submit drug acquisition cost data, elimination of AX modifier requirements for ESRD facilities starting July 2026, and new HCPCS codes for behavioral health integration services effective January 2026.

Action Required

By March 31, 2026 11:59 PM ET: Hospitals paid under OPPS must submit drug acquisition cost data via the ODACS survey if listed on the provider table. By July 1, 2026: ESRD facilities must stop using AX modifier on eligible claims and implement new billing instructions for hemodiafiltration and acute kidney injury. Immediately: Update billing systems to use new HCPCS codes G2214, 99492-99494 instead of discontinued G0512 for psychiatric collaborative care, and codes G2010, G2250, 98016 instead of G0071 for virtual communication services. Add new code G9871 for Medicare Diabetes Prevention Program and updated G0136 description for annual wellness visits.

Affected Billing Codes

994929949399494G2214G0512G0071G2010G225098016G2025G0136G9871G2211

Plan Types

Traditional Medicare

Specialties

nephrology, general-surgery, psychiatry, family-medicine, internal-medicine

2026-02-05 - Hospitals: Submit Data for OPPS Drug Acquisition Cost Survey by March 31 | Medicare/CMS | PolicyChanges.app