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Acute Inpatient PPS Transmittals

The list below shows the transmittals that are directed to the Acute Inpatient provider community, but the list may not include all instructions for which Acute Inpatient providers are responsible. For a list of all instructions, view the Transmittals web page under Regulations and Guidance.

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CR # Release Date Subject MLN Article #
5428 12/22/2006 Medicare Payment for Preadministration-Related Services Associated with IVIG Administration-Payment Extended through CY 2007 MM5428
5764 11/02/2007 New Patient Status Discharge Code 70 to Define Discharges or Transfers to Other Types of Health Care Institutions not Defined Elsewhere in the UB-04 (CMS-1450) Manual Code List MM5764
5285 03/21/2007 Provider/Supplier Enrollment Approval Letters N/A
7244 01/21/2011 Off-Cycle Release of the Inpatient Prospective Payment System (IPPS) Pricer to Accept Diagnosis Codes and to Pass a Low-Volume Payment Amount MM7244
7280 01/28/2011 Update to the Fiscal Intermediary Shared System (FISS) End of Present on Admission (POA) Indicator Logic for Version 5010 837I Electronic Health Care Claim Submissions MM7280
5597 06/29/2007 IOM Pub 100-09, Chapters 3, Provider Inquiries and Chapter 6 - Provider Customer Service Program Updates MM5597
5597 07/13/2007 IOM Pub. 100-09, Chapters 3- Provider Inquiries and Chapter6- Provider Customer Service Program Updates N/A
7278 03/10/2011 Affordable Care Act-Section 3113- Laboratory Demonstration for Certain Complex Diagnostic Tests N/A
7278 03/10/2011 Affordable Care Act-Section 3113- Laboratory Demonstration for Certain Complex Diagnostic Tests N/A
6968 08/06/2010 Payment for Implantable Tissue Markers (HCPCS Code A4648) and Implantable Radiation Dosimeters (HCPCS Code A4650) MM6968
7029 07/08/2010 Updates to the Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, Outpatient Prospective Payment System (OPPS), and Inpatient Rehabilitation Facility (IRF) PPS Changes due to the Affordable Care Act (ACA) N/A
7029 07/15/2010 Updates to the Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, Outpatient Prospective Payment System (OPPS), and Inpatient Rehabilitation Facility (IRF) PPS Changes due to the Affordable Care Act (ACA) MM7029
7004 08/13/2010 5010 Implementation--Processing Additional International Classification of Diseases, 9th Revision-Clinical Modification (ICD-9-CM) Diagnosis and Procedure Codes in Pricer, Grouper, and the Medicare Code Editor (MCE) MM7004
7024 08/13/2010 5010 Implementation-Changes to Present on Admission (POA) Indicator '1' and the K3 Segment MM7024
7134 09/17/2010 Fiscal Year (FY) 2011 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, and Inpatient Psychiatric Facility (IPF) PPS Changes MM7134
7134 10/01/2010 Fiscal Year (FY) 2011 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, and Inpatient Psychiatric Facility (IPF) PPS Changes MM7134
7172 10/15/2010 Submission of Informational Only Claims by Maryland Waiver Hospitals and Critical Access Hospitals (CAHs) for Electronic Health Records (EHR) Purposes MM7172
6885 06/04/2010 Hospital Provider Enrollment Revalidation N/A
7232 03/25/2011 Effective Date of Certified Provider or Supplier Agreement or Approval MM7232
6002 07/25/2008 Clarification on the Correct Condition Code to Report on Provider Adjustment Requests to Indicate a Health Insurance Prospective Payment System (HIPPS) Code Change N/A
6107 07/29/2008 Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) MM6107
7142 10/29/2010 Clarification of Payment Window for Outpatient Services Treated as Inpatient Services MM7142
7385 04/22/2011 Updates to Pub 100-04, Medicare Claims Processing Manual, Chapter 3: Inpatient Hospital Billing N/A
7141 11/12/2010 Expansion of Inpatient Prospective Payment System Transfer Policy to Include Critical Access Hospitals (CAHs) and Non-Participating Hospitals MM7141
7224 11/19/2010 Update to Medicare Deductible, Coinsurance and Premium Rates for 2011 MM7224
7192 12/03/2010 Outlier Reconciliation and other Outlier Manual Updates for the Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System (OPPS), Inpatient Rehabilitation Facility (IRF) PPS, Inpatient Psychiatric Facility (IPF) PPS and Long Term Care Hospital (LTCH) PPS N/A
6634 10/05/2009 Fiscal Year (FY) 2010 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, and Inpatient Psychiatric Facility (IPF) PPS Changes MM6634
6634 09/17/2009 Fiscal Year (FY) 2010 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, and Inpatient Psychiatric Facility (IPF) PPS Changes MM6634
7379 05/20/2011 Pass-through Payment for Certified Registered Nurse Anesthetist Services N/A
7404 05/27/2011 Critical Access Hospital (CAH) Optional Method Election for Outpatient Services MM7404
7553 10/28/2011 Diagnosis Code Update for Add-on Payments for Blood Clotting Factor Administered to Hemophilia Inpatients MM7553
7464 06/17/2011 Revision to Formula to Compute the Time Value of Money under the Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System (OPPS), Inpatient Rehabilitation Facility (IRF PPS), Inpatient Psychiatric Facility (IPF PPS) and Long Term Care Hospital (LTCH PPS) N/A
7508 08/26/2011 Fiscal Year (FY) 2012 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS, and Critical Access Hospital (CAH) Changes MM7508
7567 11/18/2011 Update to Medicare Deductible, Coinsurance and Premium Rates for 2012 MM7567
NA 12/02/2011 Revised Appendix A, Interpretive Guidelines for Hospitals, and Appendix W, Interpretive Guidelines for Critical Access Hospitals (CAHs) N/A
7666 12/09/2011 Off-Cycle Release of the Inpatient Prospective Payment System (IPPS) Fiscal Year (FY) 2012 Pricer MM7666
6564 12/09/2011 Verification of Status for all Hospitals Qualifying for Disproportionate Share Hospital (DSH) Payments under 42 CFR Section 412.106(c)(2), also known as the "Pickle Amendment" N/A
7671 12/16/2011 Summary of Policies in the CY 2012 Medicare Physician Fee Schedule (MPFS) Final Rule and the Telehealth Originating Site Facility Fee Payment Amount MM7671
7567 12/16/2011 Update to Medicare Deductible, Coinsurance and Premium Rates for 2012 MM7567
7505 07/22/2011 Method of Cost Settlement for inpatient Services for Rural Hospitals Participating Under Demonstrations Authorized by Section 410A of the Medicare Modernization Act. Sections 3123 and 10313 of the Affordable Care Act authorized an expansion of the demonstration and an extension for additional 5-year period. This CR gives instructions for this additional 5-year period. This CR is an extension of CR 5020 for additional 5-year period. N/A
7685 12/30/2011 Instruction to Teaching Hospital for Reporting the Internal Revenue Service (IRS) - Refund of Medical Resident FICA Taxes MM7685
7502 01/03/2012 Bundling of Payments for Services Provided to Outpatients Who Later Are Admitted as Inpatients: 3-Day Payment Window Policy and the Impact on Wholly Owned or Wholly Operated Physician Practices MM7502
7671 01/18/2012 Summary of Policies in the CY 2012 Medicare Physician Fee Schedule (MPFS) Final Rule and the Telehealth Originating Site Facility Fee Payment Amount N/A
7706 01/20/2012 Update to Pub 100-04, Medicare Claims Processing Manual, Chapter 3: Inpatient Hospital Billing N/A
7457 07/29/2011 Addition of Medical Severity Diagnosis Related Group (MS-DRG) 265 to the list subject to Inpatient Prospective Payment System (IPPS) Replaced Devices Offered Without Cost or With a Credit Policy MM7457
7661 01/27/2012 Analysis of Improper Overpayments to Design Edits to Correct these Overpayments in CWF, MCS, and FISS
7680 01/25/2012 Update to the Fiscal Year (FY) 2012 List of Codes Exempt from Reporting Present on Admission (POA) MM7680
7685 01/24/2012 Instructions to Teaching Hospitals for Reporting the Internal Revenue Service (IRS) Refund of Medical Resident FICA Taxes MM7685
7863 2012-06-08 Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) MM7863
8041 2012-08-31 Fiscal Year (FY) 2013 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital MM8041
8067 2012-11-01 Affordable Care Act (ACA) Section 3025 expansion of a field in the Inpatient Provider Specific File (PSF) MM8067
8009 2012-11-01 New Informational Unsolicited Response (IUR) Process to Identify Previously Paid Claims for Services Furnished to Medicare Beneficiaries Classified as "Unlawfully Present" in the United States MM8009
8007 2012-11-01 New Informational Unsolicited Response (IUR) Process to Identify Previously Paid Claims for Services Furnished to Incarcerated Medicare Beneficiaries MM8007
8078 2012-11-02 The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2010 for Inpatient Prospective Payment System (IPPS) Hospitals, Inpatient Rehabilitation Facilities (IRFs), and Long Term Care Hospitals (LTCHs) MM8078
7849 2012-11-02 Payment System (IPPS) Hospital Admission
8052 2012-12-07 Update to Medicare Deductible, Coinsurance and Premium Rates for 2013 MM8052
8076 2012-12-21 Implementation of the Hospital Value-Based Purchasing Program and Hospital Readmission Reduction Program for the Rural Community Hospital Demonstration for FY 2013 MM8076
8041 2013-01-04 Fiscal Year (FY) 2013 Inpatient Prospective Payment System (IPPS), Long Term Care Hospital (LTCH) PPS Changes MM8041
8139 2013-01-31 Correction to Common Working File (CWF) A/B Crossover Edit 7272 for Transfer to Home for Home Health Services
8046 2013-01-31 Modification of Payment Window Edit in the Common Working File (CWF) to Modify Diagnostic Service List MM8046
8196 2013-02-15 Bundled Payment for Care Improvement Model 4 – HI and SMI Payment Attribution and Outlier Payments
8214 2013-03-01 Inpatient Prospective Payment System (IPPS) Hospital Extensions per the American Taxpayer Relief Act of 2012 MM8214
8078 2013-03-21 The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2010 for Inpatient Prospective Payment System (IPPS) Hospitals, Inpatient Rehabilitation Facilities (IRFs), and Long Term Care Hospitals (LTCHs) MM8078
8130 2013-02-28 Inpatient Hospital Claims and Medicare Secondary Payer (MSP) Claims with Medicare Coinsurance Days and/or Medicare Lifetime Reserve Days Occurring in the Third or More Calendar Years
8185 2013-03-22 CMS Administrator’s Ruling: Part A to B Rebilling of Denied Hospital Inpatient Claims MM8185
8231 2013-07-26 Common Working File (CWF) Informational Unsolicited Response (IUR) and Reject for Hospital to Hospital Transfers. MM8231
8367 2013-07-26 Update to Post Acute Transfer Edit 7272 to Extend Home Health Agency CMS Certification Number (CCN) Range and Add Bypass.
8406 2013-08-02 The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2011 for Inpatient Prospective Payment System (IPPS) Hospitals, Inpatient Rehabilitation Facilities (IRFs), and Long Term Care Hospitals (LTCH) MM8406
8349 2013-08-16 Ambulatory Surgical Center Quality Reporting (ASCQR) Program Payment Reduction (MIEA-TRCAH, 2006) - Implementation MM8349
8421 2013-08-30 Fiscal Year (FY) 2014 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Changes
8508 2013-11-15 Immediate Suspension of Postpayment Patient Status Reviews of Inpatient Hospital Admissions 10/1/13-12/31/13
8421 2013-11-19 Fiscal Year (FY) 2014 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Changes
8508 2013-12-26 Immediate Suspension of Postpayment Patient Status Reviews of Inpatient Hospital Admissions 10/1/13-12/31/13