The Centers for Medicare & Medicaid Services (CMS) has released several targeted updates impacting coding, coverage, and payment policies—areas providers should review to ensure accurate billing and planning.
Cardiac Contractility Modulation (CCM) – Heart Failure
CMS added new guidance tied to HCPCS codes C1824, C1898, and K1030, signaling updates for providers managing patients with heart failure using CCM devices. These changes may affect how related procedures and supplies are reported and reimbursed.
Annual Wellness Visit (AWV)
Updates to HCPCS code G0136 and related materials could impact how certain components of the Annual Wellness Visit are documented and billed. Providers offering preventive services should confirm that workflows align with the revised guidance.
Clinical Laboratory Fee Schedule (CLFS)
CMS outlined several forward-looking updates for laboratory services, including:
- The next data reporting period begins May 1, 2026
- No payment reduction for calendar year 2026
- A 15% cap on payment reductions for 2027–2029
These updates are especially relevant for labs preparing for upcoming reporting requirements and assessing future reimbursement trends.
Resource: MLN Connects® Newsletter