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Medicare/CMSTraditional Medicare · Administrative · General · Ophthalmology, NephrologyMedium impact

2026-04-02 - HHS & CMS Announce Healthcare Advisory Committee Members to Improve Patient Care and Modernize the U.S. Healthcare System

Act
by Apr 7, 2026
Effective date
Apr 7, 2026
Identified
Apr 3, 2026

Summary

This MLN Connects newsletter contains multiple updates including OPPS Drug Acquisition Cost Survey deadline extension to April 7, 2026, XPHOZAN drug inclusion in ESRD bundled payment, and billing guidance for E&M services with intravitreal injections. Key billing code changes include status indicator updates and coverage determinations.

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What to do

by Apr 7, 2026 · 3 steps
01OPPS hospitals listed in the provider table must submit drug acquisition cost data using the online system and complete attestation forms.
02Immediately: Update billing systems to reflect HCPCS code Q0599 status indicator change from E1 to K.
03Review E&M billing with intravitreal injections to ensure modifier 25 is only used for significant, separately identifiable services unrelated to the injection procedure.

Codes mentioned

Q0599C1735C1736

Original notice

2026-04-02 - HHS & CMS Announce Healthcare Advisory Committee Members to Improve Patient Care and Modernize the U.S. Healthcare System
cms.gov · Always check the source before changing claims.
View original ↗

Related policy hubs

Medicare/CMS policiesOphthalmologyNephrologyCode Q0599Code C1735Code C1736

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