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Traditional MedicareAdministrativeMedium impact

2026-04-02 - HHS & CMS Announce Healthcare Advisory Committee Members to Improve Patient Care and Modernize the U.S. Healthcare System

Medicare/CMS·Ophthalmology, Nephrology·General
Effective date
Apr 7, 2026
We identified it
Apr 3, 2026
Days to comply

Summary

This MLN Connects newsletter contains multiple updates including OPPS Drug Acquisition Cost Survey deadline extension to April 7, 2026, XPHOZAN drug inclusion in ESRD bundled payment, and billing guidance for E&M services with intravitreal injections. Key billing code changes include status indicator updates and coverage determinations.

Action Required

Action needed
By April 7, 2026: OPPS hospitals listed in the provider table must submit drug acquisition cost data using the online system and complete attestation forms. Immediately: Update billing systems to reflect HCPCS code Q0599 status indicator change from E1 to K. Review E&M billing with intravitreal injections to ensure modifier 25 is only used for significant, separately identifiable services unrelated to the injection procedure.

Affected Billing Codes

Q0599
C1735
C1736