CMS recently announced several updates that may affect provider enrollment, chronic care management, opioid treatment programs, and coding requirements. Here’s what healthcare organizations should know.
Medicare Enrollment Application Changes Take Effect August 3
Clinics, group practices, and other suppliers that submit paper Medicare enrollment applications should be aware of upcoming changes to Form CMS-855B. Medicare Administrative Contractors will accept both the current and revised forms through August 2, 2026. Beginning August 3, providers must use the updated version.
Key changes include new options for managing reassignment relationships, expanded practice location types to include telehealth, and a new enrollment reason for organizations participating solely in Medicaid or another healthcare program. CMS continues to encourage providers to use PECOS for faster enrollment and information updates.
ACCESS Model Expands Support for Patients with Chronic Conditions
CMS has launched new resources for providers regarding the Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model. Beginning July 5, eligible Original Medicare beneficiaries can receive technology-supported disease management services through participating ACCESS providers.
The program is designed to support patients with chronic conditions such as diabetes, hypertension, chronic musculoskeletal pain, and depression. Services may include remote monitoring, medication management, lifestyle coaching, and wearable technology support.
Primary care providers and referring clinicians do not need to enroll in the model to participate. Providers can refer eligible patients, receive care updates, and bill for care coordination services without beneficiary cost-sharing.
Opioid Treatment Program Policy Updates for 2026
CMS has released updates affecting Opioid Treatment Programs (OTPs) through the CY 2026 Physician Fee Schedule final rule. Organizations that provide opioid use disorder treatment should review the updated Medicare Benefit Policy Manual and Medicare Claims Processing Manual guidance to ensure compliance with current requirements.
FY 2027 ICD-10 Codes Available
CMS has released the FY 2027 ICD-10 diagnosis and procedure code updates. The new codes become effective for patient encounters and discharges occurring on or after October 1, 2026.
Practices should begin reviewing the updates and preparing coding, billing, and documentation workflows ahead of implementation.
National Coverage Determination Coding Updates
CMS also updated several National Coverage Determinations (NCDs) to reflect coding and coverage changes.
Updates include the addition of CPT code 87494 for certain sexually transmitted infection screening services beginning January 1, 2026. CMS also revised coding guidance related to percutaneous image-guided lumbar decompression procedures, including the retirement of CPT code 0275T and the addition of CPT code 62330.
Practices should review these updates to ensure claims are submitted with the appropriate codes and place-of-service designations.
What This Means for Providers
From enrollment requirements and chronic care initiatives to coding revisions and treatment program updates, CMS continues to make changes that may affect practice operations and reimbursement. Healthcare organizations should review these updates carefully and work with their billing, coding, and compliance teams to ensure they remain current with Medicare requirements.
Resource: Clinics, Group Practices & Other Suppliers: Use Revised Medicare Enrollment Application Starting August 3
ACCESS Model: Learn How to Support Your Patients with Chronic Conditions
Opioid Treatment Programs: CY 2026 Updates
ICD-10 Codes: FY 2027
ICD-10 & Other Coding Revisions to National Coverage Determinations: Manual Updates