Spotlights
CMS Listening Session: Opportunities to Enhance Real-Time Claims Processing & EDI Cybersecurity Controls — August 13
Wednesday, August 13 from 3–4 pm ET
Register for this online event.
As part of CMS’ 2025 priorities, we’re holding a listening session to gather feedback from our industry partners for innovative ideas and opportunities for real-time claims processing. We’re also looking to improve Medicare’s Electronic Data Interchange (EDI) cybersecurity controls that support the security and integrity of electronic transactions physicians, suppliers, and other providers use to submit Medicare Part A and Part B claims.
We’re interested in getting your feedback based on your experiences with other insurers with real-time claims processing integration and solutions in the industry (such as revenue cycle health, denials, rejections, appeals, reimbursement time frames).
We also want to hear your feedback to improve and enhance our processes related to strengthening Medicare’s EDI cybersecurity controls to better protect the integrity and availability of information systems involved in processing Medicare claims and the security and privacy of the sensitive beneficiary data being exchanged.
Email comments or questions in advance of the listening session to cmslistens@cms.hhs.gov with “Real-Time Claims & EDI Cybersecurity” in the subject line. We may address them during the listening session or use them to develop other resources following the session.
Read the full announcement (PDF) for more information.
Physician Fee Schedule: CY 2026 Proposed Rule – Submit Comments by September 12
CMS issued the CY 2026 Physician Fee Schedule (PFS) proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the PFS and other Medicare Part B issues.
See a summary of proposed provisions. Comments are due by September 12; see the proposed rule for details on how to submit them.
Average Sales Price Files: April 2025
CMS posted the April Average Sales Price (ASP) and Not Otherwise Classified (NOC) pricing files and crosswalks on the 2025 ASP Drug Pricing Files webpage.
PrEP for HIV
Starting September 30, 2024, CMS covers Pre-exposure Prophylaxis (PrEP) using antiretroviral drugs and other related services to prevent HIV. Visit PrEP for HIV & Related Preventive Services.
Appropriate use of place-of-service codes
Review the revised Skilled Nursing Facility 3-Day Rule Billing (PDF) fact sheet and the SNF PPS section of Medicare Payment Systems to learn more about place-of-service codes.
