As CMS methodologically applied the above criteria to develop the CY 2025 list of E/M CPT/HCPCS codes subject to the comparative payment rate analysis (henceforth called "CY …
1 The codes on this list reflect services delivered primarily by physicians and non-physician practitioners (NPPs) in an office-based setting for primary care, obstetrics and gynecological, …
CCBHC Billing Codes | Medicaid
The “T” codes are for CCBHCs to bill for Demonstration encounters while the Q2 modifier can be used for billing service-level data associated with each Demonstration encounter. These codes …
CMS Technical Instructions: Diagnosis, Procedure Codes
Jul 17, 2019 · CMS expects to find diagnosis codes and procedure codes populated for most claims and encounter records in inpatient (IP), long-term care (LT) and other (OT) files. …
Medicaid Drug Rebate Program Dispute Resolution
Aug 20, 2025 · What is Medicaid Drug Rebate Dispute Resolution?The Medicaid Drug Rebate Dispute Resolution Program (DRP) is for states and/or manufacturers that are unable to …
Updated specifications, value set codes, copyright, and table source information to HEDIS Measurement Year (MY) 2025 Vol. 2 for all HEDIS measures.
As mentioned in State Health Official Letter #22-002 “Medicaid and CHIP Coverage of Stand-alone Vaccine Counseling”, CMS created these new HCPCS codes so that providers may use …
Medicaid Drug Rebate Program Data
3 days ago · The Table below, updated weekly, contains newly reported, covered outpatient drugs which were reported by participating drug manufacturers since the last quarterly update of the …
CMS Technical Instructions: Reporting Race and Ethnicity in the T …
Jun 29, 2021 · CMS Technical Instruction Use of “Other”, “Unknown” and “Unspecified” T-MSIS Race and Ethnicity Codes For the RACE (ELG213) and ETHNICITY-CODE (ELG204) data …
Adjustment and/or Dispute Codes for ROSI (Form CMS-304) and/or PQAS (Form CMS-304a) Unit rebate amount (URA) has been revised by labeler and reported to CMS, as required.