SNF Consolidated Billing: October 2026 HCPCS Quarterly Update — Systems Due October 5
CR 14561 updates HCPCS codes for SNF Consolidated Billing enforcement; systems must reflect changes by 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 R13881CP (CR 14561), published August 21, 2026 under CMS Publication 100-04, delivers the October 2026 quarterly HCPCS code update for Skilled Nursing Facility (SNF) Consolidated Billing (CB) enforcement, with an implementation date of October 5, 2026. This is a routine quarterly transmittal — not a Final Rule or LCD — but its practical effect on SNF billing operations is immediate: any HCPCS code added to or removed from the CB enforcement list as of October 5 will affect which services a SNF must bill under the Part A per-diem rather than allowing a separate Part B claim by an outside supplier or physician.
Regulatory Background
Sign in to read the full article
Create a free account to access the complete analysis, action recommendations, and related alert references.
Quick answers
Does CR 14561 apply only to SNF Part A claims, or does it also affect Part B claims submitted by outside suppliers for SNF residents?
The CB enforcement list in CR 14561 directly governs which services must be billed under the SNF Part A per-diem. Outside Part B suppliers billing for services furnished to SNF residents during a covered Part A stay are subject to denial if they bill a HCPCS code that CR 14561 has added to the CB enforcement scope. Review the full transmittal attachment to identify any newly in-scope codes before October 5, 2026.
Where can I find the specific HCPCS codes added or removed from the SNF CB enforcement list under CR 14561?
The transmittal header text for R13881CP does not enumerate individual codes. The complete code-level changes are contained in the dynamic list attachment to CR 14561, available at the CMS transmittal page: https://www.cms.gov/medicare/regulations-guidance/transmittals/2026-transmittals/r13881cp. Retrieve and review that attachment directly to identify every addition and deletion effective 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.