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Key CMS & Medicare Updates for Alabama Providers

Alabama Receives $144 Million to Strengthen Rural Health Care

Alabama is receiving $144 million through the federal Rural Health Transformation Program to support 138 grants focused on expanding access to care, improving mental health and substance abuse services, strengthening emergency and maternal care, modernizing health care technology and infrastructure, and growing the rural health workforce. The investment is expected to help improve health care delivery and access across rural communities in Alabama.

Resource: Trump Administration Announces $144 million to Improve Mental Health, Substance Abuse, Emergency and Maternal Care and Expand the Healthcare Workforce in Alabama

OIG Highlights Proper Billing for Dermatology E/M Services

The Office of Inspector General found that many Medicare dermatology claims included an E/M service on the same day as a minor surgical procedure, even though these services are generally included in the procedure’s global payment. Providers should review Medicare’s guidance on when a separate E/M service may be billed and ensure documentation supports the service and the use of modifier 25 when appropriate.

Resource: Evaluation and Management Services

October 2026 Clinical Laboratory Fee Schedule Update

CMS has issued its October 2026 quarterly update for the Clinical Laboratory Fee Schedule and related CLIA HCPCS codes. The update includes changes to CLIA edits, waived tests, and CPT codes, including new and deleted codes, effective October 1, 2026.

Resource: Clinical Laboratory Fee Schedule & Clinical Laboratory Improvement Amendments HCPCS Codes, Waived Tests & Reasonable Charge Payments: October 2026 Quarterly Update

Hospice Payment Updates for FY 2027

CMS has released its FY 2027 hospice payment update, including changes to payment rates, inpatient aggregate caps, and the wage index. The changes take effect October 1, 2026.

Resource: Hospice Payments: FY 2027 Update

National Coverage Determination Coding Updates

CMS has also published ICD-10 and other coding revisions related to National Coverage Determinations, with the latest updates taking effect January 1, 2027. Providers and billing teams should review the changes to ensure coding remains aligned with current Medicare coverage requirements.

Resource: ICD-10 & Other Coding Revisions to National Coverage Determinations: January 2027 Update (2 of 2)