Medicare/CMSMedium ImpactAdministrative

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

Published April 3, 2026Effective April 7, 2026

AI 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.

Action Required

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

Affected Billing Codes

Q0599C1735C1736

Plan Types

Traditional Medicare

Specialties

ophthalmology, nephrology, all-specialties