Reimbursement Intelligence Digest — Week of July 6, 2026
### All Specialties - **Policy Update Review**: Begin reviewing all detailed CMS Transmittals and FDA approvals for any changes relevant to your spec
Actions Required This Week
All Specialties - Policy Update Review: Begin reviewing all detailed CMS Transmittals and FDA approvals for any changes relevant to your specialty's coverage, coding, and documentation practices.
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Quick answers
How should clinical teams handle the recent updates to the Medicare Physician Fee Schedule?
Teams should review CMS Transmittal R13845CP for specific adjustments in the Medicare Physician Fee Schedule Database. Ensure that all coding and billing processes are updated to reflect these new values for compliance.
What actions should be taken regarding the FDA approvals of new molecular entities?
Ensure that each new drug approved, such as SARCLISA and BESREMI, is added to the formulary. Update coding systems to include these new entities and verify all documentation aligns with usage guidelines for compliant billing.
How do NCCI updates affect multi-specialty practices?
The NCCI Procedure-to-Procedure edits necessitate a review and update of relevant coding system protocols to ensure that all multispecialty claims adhere to the latest code pair exclusions. Review CMS Transmittal R13829CP for details.
What steps are needed for new laboratory fee schedule updates?
Clinical Laboratory teams should immediately review the updates outlined in CMS Transmittal R13855CP. Adjust charge capture processes to reflect the new fee adjustments, and ensure compliance with all necessary billing changes outlined in the documentation.
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.