CMS is reminding providers to verify information carried forward in electronic health records (EHRs) rather than relying on copied documentation from previous visits. Current records should accurately reflect the patient’s condition, provider assessment, decision-making and services provided, as conflicting or outdated information can contribute to claim denials.
Several billing and coding updates are also important for Medicare providers. COVID-19 vaccine payment allowances have been updated for the 2026–2027 season, with revised pricing for several CPT codes. Beginning October 1, 2026, RHCs and FQHCs must use the applicable CPT or HCPCS code and telehealth modifier when billing distant-site telehealth services instead of G2025. CMS also released updated guidance for Medicare Secondary Payer claims involving certain Claim Adjustment Reason Codes (CARCs), including which codes will be processed automatically, suspended for review or denied.