SNF Consolidated Billing: October 2026 HCPCS Quarterly Update — Verify by October 5
CR 14561 updates HCPCS codes used for SNF Consolidated Billing enforcement, effective October 5, 2026.
Action required by
October 5, 2026
Review the Action Required section below and ensure your team has completed all compliance steps before this date.
Transmittal R13943CP (CR 14561), published September 1, 2026, under CMS Publication 100-04, delivers the October 2026 quarterly update to HCPCS codes used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) enforcement. This is a Transmittal — not a Proposed Rule or LCD — and carries an implementation date of October 5, 2026. SNF billers and revenue cycle teams must have updated CB code lists loaded into their claims processing systems before that date to avoid erroneous denials or pass-through billing errors.
Regulatory Background
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Quick answers
Does CR 14561 apply only to Part A SNF facility claims, or does it also affect Part B claims submitted by outside suppliers billing for SNF residents?
SNF Consolidated Billing enforcement under CR 14561 operates on the shared systems and affects both the SNF's Part A claims and Part B claims submitted by outside suppliers or practitioners for services furnished to residents during a covered Part A stay. If a HCPCS code is newly added to the CB inclusion list effective October 5, 2026, a separate Part B claim for that service by a non-SNF entity will be denied. Confirm your external supplier billing agreements reflect the updated code list.
Where can I find the specific HCPCS codes added to or removed from the SNF CB enforcement list under CR 14561?
The source document for Transmittal R13943CP is a dynamic list data transmittal, meaning the operative code changes are contained in an attached data file rather than enumerated in the transmittal narrative. Access the complete affected code list directly from the full transmittal at https://www.cms.gov/medicare/regulations-guidance/transmittals/2026-transmittals/r13943cp and load that file into your CB edit tables before October 5, 2026.
Content summarized from publicly available federal publications including CMS, MAC contractors, and the Federal Register. CLV Intelligence is not affiliated with or endorsed by any government agency. This is not legal or medical advice.