February 2026 Newsletter

Short-Term Acute Care Hospital Staff Can Now Access PEPPERs

In an update for the hospital revenue cycle, CMS has notified hospital staff end users (SEUs) that they can now access Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) through the Identity & Access (I&A) Management System. The agency has provided step-by-step instructions and a quick reference guide that explain how to invite and approve an SEU and grant PEPPER access to an SEU or Comparative Billing Report business function [1] [2].

CMS Switching to Electronic Fee Coupons and CLIA Certificates

CMS has announced changes to the Clinical Laboratory Improvement Amendments (CLIA). This will include an end to paper fee coupons and CLIA certificates, which will no longer be available after March 1, 2026. After this date, the agency will stop mailing paper versions, and checks will no longer be accepted for payment [3].  

OPPS Data Survey Due March 31 

CMS has announced that the Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey (ODACS) is live for medical coding in USA. Hospitals listed under the associated provider table and that are paid under OPPS must submit drug acquisition cost data to the agency by March 31, 11:59PM ET [4].

Ambulatory Surgical Center (ASC) Payment Update Is Available

The Ambulatory Surgical Center (ASC) payment update has been released as of January 28, 2026, under MLN Matters Number MM14359. Implemented as of January 1, 2026, this update affects ASCs, physicians, suppliers, and other providers that bill Medicare Administrative Contractors (MACs) for services, including providers that outsource medical billing and coding [5].

Revision to Behavioral Health Integration Services

CMS has announced the addition of three new optional add-on HCPCS codes. These codes pertain to general behavioral health integration and psychiatric collaborative care model services when advanced primary care management services are provided. These codes are for general behavioral health integration and psychiatric collaborative care model services [6].  

Revision to Information for Rural Health Clinics

CMS has announced medical billing and coding updates for rural health clinics including: Permanent adoption of direct supervision to include audio-visual telecommunications, updates to CY 2026, discontinuation of the use of HCPCS codes G0512 and G0071, and adding a new resource link for the latest telehealth information. Rural health clinics can also continue to bill medical telehealth services under G2025 [7].

CMS Burden Reduction Conference

The 2026 CMS Burden Reduction Conference was held on February 25th. The conference featured government leadership, providers, and patient-facing clinicians in a discussion of opportunities to strengthen access to quality care and reduce administrative burden. Event materials are still available for review [8].

ICD-10 Coding Revisions to National Coverage Determinations

CMS has released the July 2026 update to CR title: International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs)-July 2026. It impacts physicians, suppliers, and providers billing MACs for services. Medical billing staff should be notified of updates to NCDs with new or deleted codes [9].

HHS Issues Notice of Benefit and Payment Parameters 

The US Department of Health and Human Services (HHS) has released the proposed “Notice of Benefit and Payment Parameters”, which applies to the 2027 plan year. The proposed rule includes provisions to improve ACA implementation, as well as parameters related to the HHS-operated risk adjustment and risk adjustment data validations (HHS-RADV), among other updates that could impact healthcare accounts receivable management [10].

Updated Version of MOON Available

CMS has an updated version of the Medicare Outpatient Observation Notice (MOON, CMS-10611). No changes were made to the delivery or timeframe requirements, but changes were released for readability and design improvements. The updated version is effective through February 28, 2029 [11].