June 2025 Newsletter

We’ve assembled the latest news for healthcare revenue cycle leaders to help you stay on top of industry challenges and adapt your revenue cycle management services.

CMS Releases HPMS Memo for May 26

CMS has published memos for week five, May 26-30. This applies to the reporting period 2025. Download is available under file name 5th-week-of-may-26-30-2025.zip [1]. This change can directly impact USA medical billing. 

MA Prescription Drug Information Released

CMS has released the Medicare Advantage Prescription Drug System payment information for June of 2025. It was issued as of May 30, 2025. The file is available for download under the name “medicare_advantage_prescription_drug_system_june_2025_payment_information_g.pdf” [2]. This release is pertinent for revenue cycle management services. 

Update to HETS Companion Guide

The agency has released the updated versions of the HETS Companion Guides. This applies to the current implementation (HETS2025-1) and the upcoming HETS2025-2 release. The guide updates are associated with changes to SOAP + WSDL ("SOAP") and MIME connectivity options [3]. Multiple sections cover impact to medical billing.  

Sustainability Changes to ACO REACH Model

CMS has announced changes to the ACO REACH model. This includes financial methodology with a goal of ensuring future cost savings for the accountable care pilot program. These changes to improve ACO REACH will be applied beginning in 2026 [4]. This update pertains to any provider engaging in medical billing for attributed beneficiaries. 

Shared Savings Program Application Dates Posted

CMS has posted the Shared Savings Program Applications dates for the January 1, 2026 start date. These dates include phase 1 submission, RFI-1, RFI-2, final disposition, as well as phase 2 dates [5].

HCPCS Quarterly Update Available

CMS has published the official update of the HCPCS medical coding system for public use. It was updated May 13, 2025 and is available under file name “July 2025 Alpha-Numeric HCPCS File (ZIP)” [6]. This update impacts medical coding in USA. 

CMS Issues New Guidance on Price Transparency

The agency has released updated price transparency guidance which can impact the hospital revenue cycle. The guidance falls under the presidential executive order, “Making America Health Again by Empowering Patients with Clear, Accurate and Actionable Healthcare Pricing Information”. The guidance falls under executive order 14221 [7].

CMS Accelerates Medicare Advantage Audits

In revenue cycle services news, CMS has premiered a strategy for expanding its auditing of Medicare Advantage plans. The announcement explains that, beginning immediately, CMS plans to audit all eligible Medicare Advantage contracts for each corresponding payment year under all newly initiated audits. The agency will also be investing additional resources to speed completions of audits for payment years 2024 going back to 2018 [8].

Public Meeting Replay for CMS’ First Biannual 2025 HCPCS

CMS announced the public meeting agenda for the 2025 Healthcare Common Procedure Coding System. The meeting was available in-person and virtually, taking place on June 2, 2025. The event featured speaker presentations and an opportunity for questions, including those pertaining to medical coding in USA [9]. Replays are archived on the CMS website.

340B Oversight Could Fall to CMS

The Department of Health and Human Services has proposed that oversight of the 340B drug pricing program fall under CMS as a component of reorganization plans. It would fall under the agency’s Program Management authority [10]. This change could impact hospital accounts receivable.