PC-Print July 2025 DP1 Updated CARC and RARC are Now Available
An updated PC-Print July 2025 DP1 is now available for download.

Users need to install the Full Install version and then run the (DP1) in order to update the Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC).

If you have questions on installing or using the PC-Print program, please contact the EDI hotline at 866-234-7331.

HCPCS Update
Updated on July 9, 2025

July 2025 Alpha-Numeric HCPCS File (file download)

CMS Publishes Program Year 2024 Open Payments Data
Today, the Centers for Medicare & Medicaid Services (CMS) published Open Payments Program Year 2024 data, along with newly submitted and updated payment records for Program Years 2018 – 2023. The data is accessible on the Open Payments Search Tool.

Open Payments is a national disclosure program that promotes transparency and accountability by making information about the financial relationships between certain pharmaceutical and medical device manufacturers and distributors and certain health care providers available to the public.

Through Open Payments, the American public has much more insight into payments and other transfers of value their healthcare providers receive from pharmaceutical and medical device companies.

Related links:

• Open Payments Data Overview 
• Open Payments Program Overview 
• Explore the Open Payments Data 

Drug and medical device companies are held accountable by law to report certain financial relationships for the purpose of the Open Payments program. Health care providers have a voluntary role in Open Payments and may review, affirm, or if necessary, dispute data that has been reported about them.

CMS issued the CY 2026 OPPS and ASC Payment System proposed rule (CMS-1834-P), introducing a series of patient-focused reforms that would modernize payments, expand access to care, and enhance hospital accountability. 

“We are advancing our mission to protect Medicare and its beneficiaries, fight fraud, and empower patients with access to the latest innovations, all while holding providers accountable and ensuring taxpayer dollars are spent wisely,” said CMS Administrator Dr. Mehmet Oz. “These reforms expand options and enforce the transparency Americans deserve to ensure they receive high-quality care without hidden costs.”

The proposed changes are designed to: 

• Reduce out-of-pocket costs for Medicare beneficiaries;
• Expand choices in where patients can receive care;
• Increase hospital accountability and transparency; and
• Safeguard the Medicare Trust Fund from waste and abuse. 

READ MORE 

CY 2026 Proposed Payment Rule & Resources

• CY 2026 PFS proposed rule 
• CY 2026 Physician Fee Schedule Proposed Rule fact sheet 
• Downloadable fact sheet on the CY 2026 Quality Payment Program proposed changes (file download)
• Proposed Medicare Shared Savings Program changes in the CY 2026 PFS Proposed Rule fact sheet 
• New Ambulatory Specialty Model (ASM) 

Proposed 2026 Hospital Outpatient Prospective Payment System and ASC Rule 
The proposed rule will be open for public comment for 60 days following its publication in the Federal Register and can be viewed online at https://www.federalregister.gov/d/2025-13360.

CMS encourages patients, providers, and stakeholders to review and submit feedback by September 15, 2025.

CY 2026 Hospital OPPS and ASC Proposed Rule (CMS-1834-P) fact sheet 

CMS Proposes Physician Payment Rule to Significantly Cut Spending Waste, Enhance Quality Measures, and Improve Chronic Disease Management for People with Medicare
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would increase quality care for Medicare recipients while significantly reducing unnecessary spending. The calendar year (CY) 2026 Medicare Physician Fee Schedule (PFS) proposed rule would advance primary care management through new quality measures, reduce waste and unnecessary use of skin substitutes, and introduce a new payment model focused on improving care for chronic disease management. 

“For the last four years, powerful interests have targeted independent medical practices,” said U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. “Thanks to Dr. Oz’s decisive leadership, this rule modernizes CMS payment systems, eliminates perverse incentives, and harnesses better data to improve care for patients with chronic disease while protecting the future of hometown doctors.” 

“We are taking meaningful steps to modernize Medicare, cut waste, and improve patient care,” said CMS Administrator Dr. Mehmet Oz. “We’re making it easier for seniors to access preventive services, incentivizing health care providers to deliver real results, and cracking down on abuse that drives up costs. This is how we protect Medicare for the next generation while helping Americans live longer, healthier lives.

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CMS Finds 2.8 Million Americans Potentially Enrolled in Two or More Medicaid/ACA Exchange Plans Unnecessary, Duplicate Enrollment Wasting $14 Billion Annually
The Centers for Medicare & Medicaid Services (CMS) continue to crush fraud, waste, and abuse in America’s healthcare programs by stopping duplicative enrollment in government health programs, with the potential to save taxpayers approximately $14 billion annually. 

A recent analysis of 2024 enrollment data identified 2.8 million Americans either enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) in multiple states or simultaneously enrolled in both Medicaid/CHIP and a subsidized Affordable Care Act (ACA) Exchange plan. 

CMS is taking action to ensure individuals are only enrolled in one program and to stop the federal government from paying multiple times for these individuals to receive health coverage. In addition, as a result of the One Big Beautiful Bill Act, CMS now has new tools to prevent the federal government from paying twice for the same person’s care—saving billions and restoring integrity to the system.

"HHS staff uncovered millions of Americans who were illegally or improperly enrolled in Medicaid and ACA plans," said U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. "Under the Trump Administration, we will no longer tolerate waste, fraud, and abuse at the expense of our most vulnerable citizens. With the passage of the One Big Beautiful Bill, we now have the tools to strengthen these vital programs for generations to come."

READ MORE 

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