Traditional MedicareBilling CodesHigh impact
R13929CP: Body: MLN Connects® Newsletter MessageMedicare Physician Fee Schedule Database: October UpdateSee the instructions to your Medicare Administrative Contractor (MAC) (PDF) to learn about the October quarterly updates to the Medicare
Medicare/CMS - Transmittals·CMS Transmittal
Effective date
Oct 1, 2026
We identified it
Sep 29, 2026
Summary
CMS has issued a quarterly update to the Medicare Physician Fee Schedule Database (MPFSDB) effective October 5, 2026. This update includes new HCPCS codes (G0685, 87638, A9613, J0643, J0644, J0871, J1757, J1818, J1946, J1947, J1957), deleted codes (J0640, J1941, J1953), and revised code descriptors. Medicare contractors must download and implement the updated payment data into their systems, and providers must receive 30-day notice before implementation.
Action Required
REQUIREMENTS:
- By September 5, 2026 (30 days before October 5 implementation): Billing team must provide written notice to all providers regarding the MPFSDB update and new/deleted codes.
- By October 5, 2026: Update billing software and fee schedules with revised payment data, including removal of deleted codes (J0640, J1941, J1953) and addition of new codes (G0685, 87638, A9613, J0643, J0644, J0871, J1757, J1818, J1946, J1947). Update updated code descriptor for A9595.
- Billing team must verify that claims submitted with deleted codes after October 5, 2026 will be rejected by Medicare contractors.
- Do NOT search files to retract payment for claims already paid prior to the effective date; however, adjust any claims brought to your attention.
- Ensure testing and production environments in billing systems are updated with new payment indicator values for all affected codes.