Federal Register / Vol. 87, No. 93 / Friday, May 13, 2022 / Notices 29327 

severe infections in humans. NHPs may 

not be imported as pets and may only 

be imported for bona fide scientific, 

educational, or exhibition purposes, as 

defined in the regulations. Forms for the 

importation of NHPs are currently under 

information collection 0920–0263. 

These forms will move into this new 

information collection to consolidate all 

forms related to the importation of 

animals or animal products into one 

collection. 

A new form to request a permit to 

import a regulated animal that is neither 

a dog nor an NHP (e.g., turtles, African 

rodents, civets) is included in this 

information collection. It also 

incorporates the addition of bats, which 

is currently approved under OMB 

control number 0920–0199. 

Regarding human remains, the 

Division of Global Migration and 

Quarantine (DGMQ) works with the 

Division of Select Agents and Toxins 

(DSAT) on the importation for human 

remains. DGMQ requests death 

certificates from those wishing to import 

remains and then determines if the 

importer will need a permit, which is 

issued by DSAT and will remain in 

0920–0199. 

Lastly, people importing animal 

products must make a statement or 

provide documentation demonstrating 

that the animal product is not 

infectious. 

CDC requests OMB approval for an 

estimated 60,219 annual burden hours. 

There are no costs to respondents other 

than their time to participate. 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondents Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Dog Importers (42 CFR 71.51(c)(2), (d)) ........ Dog Permit Application Form ......................... 60,000 1 60/60 

NHP Importers (42 CFR 71.53) ...................... NHP Shipment Arrival Notification Form ....... 120 1 15/60 

First Time NHP Importer (42 CFR 71.53) ...... NHP Importer Form ........................................ 15 1 120/60 

Regulated Animal Importer (42 CFR 71) ........ Other animal import form ............................... 2 1 30/60 

Dog and Cat Importers (42 CFR 71.51(b)(3)) Record of sickness or death .......................... 43 1 60/60 

Human Remains Importers (42 CFR 71.55, 

42 CFR 71.32).

Provide death certificate ................................ 50 1 15/60 

Importer of animal products (42 CFR 71.32) Statement or documentation of non-infectiousness.391 1 15/60 

NHP Importers (42 CFR 71.53) ...................... Lab-to-Lab Form ............................................ 2 1 60/60 

NHP Importers (42 CFR 71.53) ...................... Zoo-to-Zoo Form ............................................ 2 1 60/60 

Jeffrey M. Zirger, 

Lead, Information Collection Review Office, 

Office of Scientific Integrity, Office of Science, 

Centers for Disease Control and Prevention. 

[FR Doc. 2022–10374 Filed 5–12–22; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–9136–N] 

Medicare and Medicaid Programs; 

Quarterly Listing of Program 

Issuances—January Through March 

2022 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This quarterly notice lists 

CMS manual instructions, substantive 

and interpretive regulations, and other 

Federal Register notices that were 

published from January through March 

2022, relating to the Medicare and 

Medicaid programs and other programs 

administered by CMS. 

FOR FURTHER INFORMATION CONTACT: It is 

possible that an interested party may 

need specific information and not be 

able to determine from the listed 

information whether the issuance or 

regulation would fulfill that need. 

Consequently, we are providing contact 

persons to answer general questions 

concerning each of the addenda 

published in this notice. 

Addenda Contact Phone No. 

I CMS Manual Instructions ......................................................................................................... Ismael Torres ..................... (410) 786–1864 

II Regulation Documents Published in the Federal Register ................................................... Terri Plumb ......................... (410) 786–4481 

III CMS Rulings .......................................................................................................................... Tiffany Lafferty ................... (410) 786–7548 

IV Medicare National Coverage Determinations ........................................................................ Wanda Belle, MPA ............. (410) 786–7491 

V FDA-Approved Category B IDEs ............................................................................................ John Manlove ..................... (410) 786–6877 

VI Collections of Information ...................................................................................................... William Parham .................. (410) 786–4669 

VII Medicare—Approved Carotid Stent Facilities ....................................................................... Sarah Fulton, MHS ............ (410) 786–2749 

VIII American College of Cardiology-National Cardiovascular Data Registry Sites .................. Sarah Fulton, MHS ............ (410) 786–2749 

IX Medicare’s Active Coverage-Related Guidance Documents ................................................ JoAnna Baldwin, MS .......... (410) 786–7205 

X One-time Notices Regarding National Coverage Provisions ................................................. JoAnna Baldwin, MS .......... (410) 786–7205 

XI National Oncologic Positron Emission Tomography Registry Sites ..................................... David Dolan, MBA .............. (410) 786–3365 

XII Medicare-Approved Ventricular Assist Device (Destination Therapy) Facilities .................. David Dolan, MBA .............. (410) 786–3365 

XIII Medicare-Approved Lung Volume Reduction Surgery Facilities ......................................... Sarah Fulton, MHS ............ (410) 786–2749 

XIV Medicare-Approved Bariatric Surgery Facilities .................................................................. Sarah Fulton, MHS ............ (410) 786–2749 

XV Fluorodeoxyglucose Positron Emission Tomography for Dementia Trials .......................... David Dolan, MBA .............. (410) 786–3365 

All Other Information ..................................................................................................................... Annette Brewer .................. (410) 786–6580 


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29328 Federal Register / Vol. 87, No. 93 / Friday, May 13, 2022 / Notices 

SUPPLEMENTARY INFORMATION: 

I. Background 

The Centers for Medicare & Medicaid 

Services (CMS) is responsible for 

administering the Medicare and 

Medicaid programs and coordination 

and oversight of private health 

insurance. Administration and oversight 

of these programs involves the 

following: (1) Furnishing information to 

Medicare and Medicaid beneficiaries, 

health care providers, and the public; 

and (2) maintaining effective 

communications with CMS regional 

offices, state governments, state 

Medicaid agencies, state survey 

agencies, various providers of health 

care, all Medicare contractors that 

process claims and pay bills, National 

Association of Insurance Commissioners 

(NAIC), health insurers, and other 

stakeholders. To implement the various 

statutes on which the programs are 

based, we issue regulations under the 

authority granted to the Secretary of the 

Department of Health and Human 

Services under sections 1102, 1871, 

1902, and related provisions of the 

Social Security Act (the Act) and Public 

Health Service Act. We also issue 

various manuals, memoranda, and 

statements necessary to administer and 

oversee the programs efficiently. 

Section 1871(c) of the Act requires 

that we publish a list of all Medicare 

manual instructions, interpretive rules, 

statements of policy, and guidelines of 

general applicability not issued as 

regulations at least every 3 months in 

the Federal Register. 

II. Format for the Quarterly Issuance 

Notices 

This quarterly notice provides only 

the specific updates that have occurred 

in the 3-month period along with a 

hyperlink to the full listing that is 

available on the CMS website or the 

appropriate data registries that are used 

as our resources. This is the most 

current up-to-date information and will 

be available earlier than we publish our 

quarterly notice. We believe the website 

list provides more timely access for 

beneficiaries, providers, and suppliers. 

We also believe the website offers a 

more convenient tool for the public to 

find the full list of qualified providers 

for these specific services and offers 

more flexibility and ‘‘real time’’ 

accessibility. In addition, many of the 

websites have listservs; that is, the 

public can subscribe and receive 

immediate notification of any updates to 

the website. These listservs avoid the 

need to check the website, as 

notification of updates is automatic and 

sent to the subscriber as they occur. If 

assessing a website proves to be 

difficult, the contact person listed can 

provide information. 

III. How To Use the Notice 

This notice is organized into 15 

addenda so that a reader may access the 

subjects published during the quarter 

covered by the notice to determine 

whether any are of particular interest. 

We expect this notice to be used in 

concert with previously published 

notices. Those unfamiliar with a 

description of our Medicare manuals 

should view the manuals at http://

www.cms.gov/manuals. 

The Director of the Office of Strategic 

Operations and Regulatory Affairs of the 

Centers for Medicare & Medicaid 

Services (CMS), Kathleen Cantwell, 

having reviewed and approved this 

document, authorizes Trenesha FultzMimms, who is the Federal Register 

Liaison, to electronically sign this 

document for purposes of publication in 

the Federal Register. 

Trenesha Fultz-Mimms, 

Federal Register Liaison, Department of 

Health and Human Services. 

BILLING CODE 4120–01–P 


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Federal Register / Vol. 87, No. 93 / Friday, May 13, 2022 / Notices 29329 


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Publication Dates for the Previous Four Quarterly Notices 

We publish this notice at the end of each quarter reflecting 

information released by CMS during the previous quarter. The publication 

dates of the previous four Quarterly Listing of Program Issuances notices 

are: May 3, 2021 (86 FR 23373), August 17, 2021 (86 FR 45986), 

November 18, 2021 (86 FR 64492) and February 9, 2022 (87 FR 7458). 

We are providing only the specific updates that have occurred in the 

3-month period along with a hyperlink to the website to access this 

information and a contact person for questions or additional information. 

Addendum I: Medicare and Medicaid Manual Instructions 

(January through March 2022) 

The CMS Manual System is used by CMS program components, 

partners, providers, contractors, Medicare Advantage organizations, and 

State Survey Agencies to administer CMS programs. It offers day-to-day 

operating instructions, policies, and procedures based on statutes and 

regulations, guidelines, models, and directives. In 2003, we transformed the 

CMS Program Manuals into a web user-friendly presentation and renamed 

it the CMS Online Manual System. 

How to Obtain Manuals 

The Internet-only Manuals (IOMs) are a replica of the Agency's 

official record copy. Paper-based manuals are CMS manuals that were 

officially released in hardcopy. The majority of these manuals were 

transferred into the Internet-only manual (IOM) or retired. Pub 15-1, Pub 

15-2 and Pub 45 are exceptions to this rule and are still active paper-based 

manuals. The remaining paper-based manuals are for reference purposes 

only. If you notice policy contained in the paper-based manuals that was 

not transferred to the IOM, send a message via the CMS Feedback tool. 

Those wishing to subscribe to old versions of CMS manuals should 

contact the National Technical Information Service, Department of 
29330 Federal Register / Vol. 87, No. 93 / Friday, May 13, 2022 / Notices 


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Commerce, 5301 Shawnee Road, Alexandria, VA 22312 Telephone 

(703-605-6050). You can download copies of the listed material free of 

charge at: http://cms.gov/manuals. 

How to Review Transmittals or Program Memoranda 

Those wishing to review transmittals and program memoranda can 

access this information at a local Federal Depository Library (FDL). Under 

the FDL program, government publications are sent to approximately 1,400 

designated libraries throughout the United States. Some FDLs may have 

arrangements to transfer material to a local library not designated as an 

FDL. Contact any library to locate the nearest FDL. This information is 

available at http://www.gpo.gov/libraries/ 

In addition, individuals may contact regional depository libraries 

that receive and retain at least one copy of most federal government 

publications, either in printed or microfilm form, for use by the general public. These libraries provide reference services and interlibrary loans; 

however, they are not sales outlets. Individuals may obtain information 

about the location of the nearest regional depository library from any 

library. CMS publication and transmittal numbers are shown in the listing 

entitled Medicare and Medicaid Manual Instructions. To help FDLs locate 

the materials, use the CMS publication and transmittal numbers. For 

example, to find the manual for Updates to Medicare Benefit Policy Manual 

and Medicare Claims Processing Manual for Opioid Treatment Programs and New Modifier for Audio-only Services, use (CMS-Pub. 100-02) 

Transmittal No. 11219. 

Addendum I lists a unique CMS transmittal number for each 

instruction in our manuals or program memoranda and its subject number. 

A transmittal may consist of a single or multiple instruction(s). Often, it is 

necessaiy to use information in a transmittal in conjunction with 

information currently in the manual. 

Fee-For Service Transmittal Numbers 

Please Note: Beginning Friday, March 20, 2020, there will be the 

following change regarding the Advance Notice of Instructions due to a 

CMS internal process change. Fee-For Service Transmittal Numbers will 

no longer be determined by Publication The Transmittal numbers will be 

issued by a single numerical sequence beginning with Transmittal Number 

10000. 

For the purposes of this quarterly notice, we list only the specific 

updates to the list of manual instructions that have occurred in the 3-month 

period. This information is available on our website at 

www.cms.gov/Manuals. 

Transmittal 

Number 

Manual/Subject/Publication Number 

11223 11275 11297 11181 11219 11249 11272 11288 11171 11214 11263 11272 11171 11180 

Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 

Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 

Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 

Internet-Only Manual Updates (IOM) for Critical Care, Split/Shared 

Evaluation and Management Services, Teaching Physicians, and Physician 

Assistants 

Updates to Medicare Benefit Policy Manual and Medicare Claims Processing 

Manual for Opioid Treatment Programs and New Modifier for Audio-only 

Services 

Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidcntialitv of Instruction 

An Omnibus CR Covering: (I) Removal of Two National Coverage 

Determination (NCDs ), (2) Updates to the Medical Nutrition Therapy (MNT) 

Policy, and (3) Updates to the Pulmonary Rehabilitation (PR), Cardiac 

Rehabilitation (CR), and Intensive Cardiac Rehabilitation (ICR) Conditions of 

Coverage Pulmonary Rehabilitation (PR) Program Services Furnished On or 

After January I, 2010 Cardiac Rehabilitation (CR) and Intensive Cardiac 

Rehabilitation (ICR) Services Furnished on or After Januarv 1, 2010 

Internet-Only Manual Updates (IOM) for Critical Care, Split/Shared 

Evaluation and Management Services, Teaching Physicians, and Physician 

Assistants 

National Coverage Determination (NCD) 270.3 Blood-Derived Products for 

Chronic, Non-Healing Wounds Blood-Derived Products for Chronic, NonHealing Wounds 

National Coverage Determination (NCD) 270.3 Blood-Derived Products for 

Chronic, Non-Healing Wounds 

Revisions to National Coverage Determination (NCD) 240.2 (Home Use of 

Oxygen) and 240.2.2 (Home Oxygen Use for Cluster Headache) Home Use of Oxvgen Home O,roo-en Use to Treat Cluster Headache (CH) 

An Omnibus CR Covering: (!) Removal of Two National Coverage 

Determination (NCDs ), (2) Updates to the Medical Nutrition Therapy (MNT) 

Policy, and (3) Updates to the Puhnonary Rehabilitation (PR), Cardiac 

Rehabilitation (CR), and Intensive Cardiac Rehabilitation (ICR) 

Conditions of Coverage Medical Nutrition Therapy 

Enteral and Parenteral Nutritional Therapy 

Positron Emission Tomographv (PET) Scans 

National Coverage Determination (NCD) 270.3 Blood-Derived Products for 

Chronic, Non-Healing Wounds 

Autologous Platelet-Rich Plasma (PRP) for Chronic Non-Healing Wounds 

Policy 

Healthcare Common Procedure Coding System (HCPCS) Codes, Diagnosis 

Coding and Frequency Requirements 

Types of Bill (TOB) 

Payment Method Place of Service (POS) for Professional Claims 

Medicare Sununary Notices (MS~s), Remittance Advice Remark Codes 

(RARCs), Claim Adjustment Reason Codes (CARCs) and Group Codes 

Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 
Federal Register / Vol. 87, No. 93 / Friday, May 13, 2022 / Notices 29331 


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11186 Calendar Year (CY) 2022 Annual Update for Clinical Laboratory Fee Effect of a BFCC-QIO Expedited Determination on Continuation of Care 

Schedule and Laboratorv Services Subiect to Reasonable Charge Pavment RiPht to Pursue the Standard Claims Aooeal Process 

11187 Issued to a specific audience, not posted to Internet/Intranet due to a 11215 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentialitv of Instruction Confidentialitv of Instruction 

11188 New Waived Tests 11219 Updates to Medicare Benefit Policy Manual and Medicare Claims Processing 

11189 Update to the Internet Only Manual (IOM) Publication (Pub.) 100-04, Manual for Opioid Treatment Programs and New Modifier for Audio-only 

Chapter 3, Section 40.2.4 Inpatient Prospective Payment System (IPPS) Services 

Transfers Between Hospitals Site of service (telecommunications) 

!PPS Transfers Detween Hospitals Coding 

11200 Implementation of the GV Modifier for Rural Health Clinics (RHCs) and Adjustments to the Bundled Payment Rate 

Federally Qualified Health Centers (FQHCs) for Billing Hospice Attending Locality Adiustments 

Physician Services 11221 Quarterly Update for Clinical Laboratory Fee Schedule (CLFS) and 

RH Cs and FQHCs for Billing Hospice Attending Physician Services Laboratorv Services Subiect to Reasonable Charge Pavment 

11202 Issued to a specific audience, not posted to Internet/Intranet due to a 11224 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction Confidentialitv of Instruction 

11208 Healthcare Common Procedure Coding System (HCPCS) Codes Subject to 11225 Issued to a specific audience, not posted to Internet/Intranet due to a 

and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Conlidenlialilv oflnslruclion 

Edits 11231 Issued to a specific audience, not posted to Internet/Intranet due to a 

11210 Expedited Review Process for Hospital Inpatients in Original Medicare Confidentialitv of Instruction 

Expedited Determinations oflnpalienl Hospilal Discharges 11233 Issued lo a specific audience, nol posted lo lnlemel/Inlranel due lo a 

Statutory Authority Confidentialitv of Instruction 

Scope 11239 Issued to a specific audience, not posted to Internet/Intranet due to a 

Exceptions Confidcntialitv of Instruction 

Important Message from Medicare (IM) 11241 Issued to a specific audience, not posted to Internet/Intranet due to a 

Alterations to the IM Confidentialitv of Instruction 

Completing the TM 11251 Claim Status Category and Claim Status Codes Update 

Hospital Delivery of the IM 

Required Delivery Timeframes First IM Follow up copy of the IM Refusal to Sign the IM 

11255 April 2022 Update to the Medicare Severity - Diagnosis Related Group (MSDRG) Grouper and Medicare Code Editor (MCE) Version 39.1 for the 

International Classification of Diseases, Tenth Revision (ICD-10) Diagnosis 

Codes for 2019 Novel Coronavirus (COVID-19) Vaccination Status and 

ICD-10 

Ensuring Beneficiary Comprehension 

IM Delivery to Representatives 

Procedure Coding System (PCS) Codes for Introduction or Infusion of 

Theraoeutics and Vaccines for COVID-19 Treatment 

Notice Retention for the IM 11257 Shared Svstem Support Hours for Application Programming Interfaces (APis) 

Expedited Determination Process 

Beneficiary Responsibilities 

Timeframe for Requesting an Expedited Determination 

Provide Information to BFCC-QIO 

Beneficiary Liability During BFCC-QIO Review 

Untimely Requests for Review 

Hospital Responsibilities 

The Detailed Notice of Discharge (DND 

BFCC-QIO Responsibilities Receive Beneficiary Requests for Expedited Review 

Notify Hospitals and Allow Explanation of Why Covered Services Should 

End 

Validate Delivery ofthe IM 

Solicit the Views of the Beneficiary 

Solicit the Views of the Hospital 

Make Determinations and Notify Required Parties 

Effect of a BFCC-QIO Expedited Determination 

Right to Pursue an Expedited Reconsideration 

Effect of a BFCC-QIO Expedited Determination on Continuation of Care 

Right to Pursue the Standard Claims Aooeal Process 

11258 Gap Billing Between Hospice Transfers 11259 Issued to a specific audience, not posted to Internet/Intranet due to a 

Sensitivity of Instruction 

11263 Revisions to l\ational Coverage Determination (NCD) 240.2 (Home Use of 

Oxygen) and 240.2.2 (Home Oxygen Use for Cluster Headache) Oxygen and Oxvgen E<1uinment 

11265 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentialitv of Instruction 

11267 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentialitv of Instruction 

11268 Quarterly Update to the Medicare Physician Fee Schedule Database 

(MPFSDB) - Aoril 2022 Uodate 

11269 Issued to a specific audience, not posted to Internet/Intranet due to a 

Sensitivity oflnslruclion 

11271 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentialitv of Instruction 

11272 An Omnibus CR Covering: (1) Removal of Two National Coverage 

Determination (NCDs), (2) Updates to the Medical Nutrition Therapy (MNT) 

Policy, and (3) Updates to the Pulmonary Rehabilitation (PR), Cardiac 

11214 Effect of a BFCC-QIO Expedited Determination 

Ri2:ht to Pursue an Exnedited Reconsideration 

Rehabilitation (CR), and Intensive Cardiac Rehabilitation (ICR) Conditions of 

Coverage Medical Nutrition Therapy (MNT) Services 

General Conditions and Limitations on Coverage 
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Referrals for MNT Services 11320 Issued to a specific audience, not posted to Internet/Intranet due to a 

Dieticians and Nutritionists Performing MNT Services Confidentiality of Instruction 

Payment for MNT Services 

General Claims Processing Information 11197 Issued to a specific audience, not posted to Internet/Intranet due to a 

Rural Health Centers (RHCs)/Federally Qualified Health Centers (FQHCs) Confidentiality of Instruction 

Special Billing Instructions 

Common Working File (CWF) Edits 

Claims Processing Requirements for CR and ICR Services Furnished On or 

11199 Notice of New Interest Rate for Medicare Overpayments and Underpayments 

-1st Otr Notification for FY 2022 

After January I, 2010 

Frequency Edits for CR and ICR Claims 

ICR Program Services Furnished On or After January 1, 2010 

11203 Notice of New Interest Rate for Medicare Overpayments and Underpayments 

-2nd Qtr Notification for FY 2022 

Coding Requirements for ICR Services Furnished On or After January 1, None 

2010 

PR Program Services Furnished On or After January 1, 2010 

Coding Requirements for PR Services Furnished On or After January I, 

2010 

Edits for CR Services Exceeding 36 Sessions 

Edits for PR Services Exceeding 72 Sessions 

11274 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 

11278 Quarterly Update to the End-Stage Renal Disease Prospective Payment 

Svstem CESRD PPS) 

11280 Gap Billing Between Hospice Transfers 

11284 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 

11287 Internet-Only Manual Updates for Critical Care Evaluation and Management 

Services 

Definition of a Global Surgical Package 

Billing Requirements for Global Surgeries 

Claims Review for Global Surgeries 

Adiudication of Claims for Global Surgeries 

11295 April Quarterly Update for 2022 Durable Medical Equipment, Prosthetics, 

Orthotics and Suoolies <DMEPOS) Fee Schedule 

11299 Quarterly Update ofHCPCS Codes Used for Home Health Consolidated 

Billing Enforcement 

11300 Issued to a specific audience, not posted to Internet/Intranet due to a 

Sensitivitv oflnstruction 

11301 Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code 

(CARC), Medicare Remit Easy Print (MREP) and PC Print Update 

11302 Combined Common Edits/Enhancements Modules (CCEM) Code Set Uodate 

11303 April 2022 Update of the Ambulatory Surgical Center (ASC) Payment 

System 

11304 April 2022 Integrated Outpatient Code Editor (I/OCE) Specifications Version 

23.1 

11305 April 2022 Update of the Hospital Outpatient Prospective Payment System 

COPPS) 

11309 Quarterly Update to the National Correct Coding Initiative [NCC!] 

Procedure-lo-Procedure [PTP] Edits Version 28.2 EITeclive July 1 2022 

11177 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 

11206 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 

11207 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality oflnstruction 

11211 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 

11212 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 

11216 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality of Instructions 

11217 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality of Instructions 

11218 Updates to Chapter 4 in Publication (Pub.) 100-08, Including Removal of 

Requests for Anticipated Payment (RAP) Suppressions and Updates to 

Exhibit 16 - Model Pavment Susoension Letters in Pub. 100-08 

11246 Updates to Chapter 4 in Publication (Pub.) 100-08, Including Removal of 

Requests for Anticipated Payment (RAP) Suppressions and Updates to 

Exhibit 16 - Model Pavment Suspension Letters in Pub. 100-08 

11250 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality of Instructions 

11253 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality of Instructions 

11256 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality of Instructions 

11283 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality of Instructions 

11308 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality of Instructions 

11314 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality of Instructions 

11315 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality of Instructions 

11310 Issued to a specific audience, not posted to Internet/Intranet due to a 

Confidentiality of Instruction 

11311 Issued to a specific audience, not posted to Internet/Intranet due to a 

Sensitivitv oflnstruction 

11313 Issued to a specific audience, not posted to Internet/Intranet due to a 

Sensitivitv oflnstruction 

11319 Issued to a specific audience, not posted to Internet/Intranet due to a 

11222 Issued to a specific audience, not posted to Internet/Intranet due to 

Confidentiality of Instructions 

11276 The Supplemental Security Income (SST)/Jvfedicare Reneficiary Data for 

Fiscal Year (FY) 2020 for Inpatient Prospective Payment System (IPPS) 

Hospitals, Inpatient Rehabilitation Facilities (IRFs ), and Long Term Care 

Ilosoitals (L TCIIs) 

Confidentialitv of Instruction 
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11298 Issued to a specific audience, not posted to Internet'Intranet due to 11209 Send Electronic Funds Transfer (EFT) Information from Provider Enrollment 

Confidentiality of Instructions Chain and Ownership System (PECOS) to Fiscal Intermediary Shared System 

(FISS) - Implementation CR, Consolidation of January 2022 and April 2022 

None Releases 

11220 Updating the 32287 Reason Code Edit in the Fiscal Intermediary Shared 

None System (FISS) to Allow Processing of Claims Containing Healthcare 

Common Procedure Coding Svstem (HCPCS) Code Q0249 

None 11226 User Change Request (UCR): Fiscal Intermediary Shared System (FISS) -

Expert Claims Processing System (ECPS) Enhancement to Process Notice of 

None Elections (NOEs) with Frequency B or E 

11227 User CR: MCS - Test UAT Future Dates Beyond the Current Year 

None 11228 User Change Request (UCR): Fiscal Intermediary Shared System (FISS) -

MAP1181 Online Grab Request to Include Line Numbers 

None 11229 User Change Request (UCR): Fiscal Intermediary Shared System (FISS) -

Clear PRMNAPRO Screen Upon Completion of Job 

11201 ESRD Treatment Choices (ETC) Model Demo Priorities Correction 

11242 ESRD Treatment Choices (ETC) Model Perfonnance Payment Adjustment 

(PPA) - Facility Component (Implementation CR) 

11244 Issued to a specific audience, not posted to Internet'Intranet due to Sensitivity 

oflnstructions 

11245 Issued to a specific audience, not posted to Internet'Intranet due to Sensitivity 

oflnstructions 

11266 ESRD Treatment Choices (ETC) Model Demo Priorities Correction 

11294 Issued to a specific audience, not posted to Internet'Intranet due to 

Confidentiality of Instructions 

11230 User Change Request (UCR): Fiscal Intermediary Shared System (FISS) -

Modifv Reason Code 38205 to Include All Patient Status Codes 

11232 User Change Request (UCR): Fiscal Intermediary Shared System (FISS) -

Claim Page 2 Adjustment Document Control ~umber (AD DCN) to Match 

the Claim Page 6 Cross Reference DCN (XREF DCN) 

11234 User Change Request (UCR): Fiscal Intermediary Shared System (FISS) -

Medicare Secondary Payer (MSP) Reports RPT800AA and RPT800AB 

Updates 

11235 User Change Request (UCR): Fiscal Intermediary Shared System (FISS) -

Modify Access to Reason Code File Uodate to Allow Narrative Onlv Updates 

11236 Updating the Exempt Diagnosis Codes Present on Admission (POA) File to 

11175 CY2022 Telehealth Update Medicare Physician Fee Schedule 

11178 Skilled Nursing Facility (SNF) Claims Processing Update to Fiscal Year End 

(FYE) Edits 

11179 International Classification of Diseases, 10th Revision (ICD-10) and Other 

Coding Revisions to National Coverage Determinations (NCDs) -- April 2022 

(CR I of2) 

11185 CR: MCS - Enhancement to Automate the XHIC Error Process 

11190 Correction to Processing When Osteoporosis Drugs Are Billed for Other 

Indications 

11191 New Occurrence Span Code and Revenue Code for Acute Hospital Care at Xs 

k+/*Home 

11192 Updating the 32287 Reason Code Edit in the Fiscal Intermediary Shared 

Accommodate Multiole Effective and Termination Dates 

11237 Issued to a specific audience, not posted to Internet'Intranet due to 

Confidentialitv of Instructions 

11238 ViPS Medicare System (VMS) - Track Claim Counter Activity in SuperOp -

Imnlementation oflJser CR 11558 

11240 Updates to the Common Working File (CWF) for Editing and Claims 

Processing to Allow Medicare Fee-For-Service (FFS) Coverage of Kidney 

Acquisition Costs for Medicare Advantage (MA) Beneficiaries Provided by 

Marvland Waiver (MW) Hospitals 

11243 Method of Payment and Cost Settlement for Inpatient Services for Hospitals 

Participating under the Rural Comrnunitv Hospital Demonstration 

11248 Nursing and Allied Health Medicare Advantage Payment - Revision to CY 

2018 

System (FISS) to Allow Processing of Claims Containing Healthcare 

Common Procedure Coding Svstem (HCPCS) Code Q0249 

11193 Issued to a specific audience, not posted to Internet'Intranet due to Sensitivity 

oflnstrncti ons 

11252 User CR: ViPS Medicare System (VMS) - Update Beneficiary Information 

Tracking System (BITS) Menu to Include a Selection Field of Electronic 

Submission of Medical Documentation (esMD) Transaction ID 

11254 Mobile Personal Identitv Verification (PIV) Station 11194 Prevent Loading of Dental HCPCS Codes in the Fiscal Intermediary Shared 

Svstem (FISS) 

11196 MAC Participation in Change Request (CR) Development 

11198 Implementation of Medicare Administrative Contractor (MAC) Appeals 

Upload Process Changes for the Recovery Audit Contractor (RAC) Data 

12562 Common Working File (CWF) Editing- National Coverage Determination 

(NCO) 270.3 Blood-Derived Products for Chronic, Non-Healing Wounds 

12564 International Classification of Diseases, 10th Revision (ICD-10) and Other 

Coding Revisions to National Coverage Determinations (NCDs)-- July 2022 

Warehouse (RA CDW) and Addition of Disposition Category "U" to RA CDW 

Anneals Lavout File None 

11204 Modify Fiscal Intermediary Shared System (FISS) Existing Logic for Vaccine 

Administration Codes for Non-outpatient Prospective Payment System (Non- None 

OPPS) Island Providers 

11205 Issued to a specific audience, not posted to Internet'Intranet due to Sensitivity None 

oflnstructions 
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Addendum II: Regulation Documents Published 

in the Federal Register (January through March 2022) 

Regulations and Notices 

Regulations and notices are published in the daily Federal 

Register. To purchase individual copies or subscribe to the Federal 

Register, contact GPO at www.gpo.gov/fdsys. When ordering individual 

copies, it is necessary to cite either the date of publication or the volume 

number and page number. 

The Federal Register is available as an online database through 

GPO Access. The online database is updated by 6 a.m. each day the 

Federal Register is published. The database includes both text and 

graphics from Volume 59, Number 1 (January 2, 1994) through the present 

date and can be accessed at http://www.gpoaccess.gov/fr/index.html. The 

following website http://www.archives.gov/federal-register/ provides 

information on how to access electronic editions, printed editions, and 

reference copies. 

This information is available on our website at: 

https://www.cms.gov/fi1es/document/regslq22qpu.pdf 

For questions or additional information, contact Terri Plumb 

(410-786-4481). 

Addendum m: CMS Rulings 

(January through March 2022) 

CMS Rulings are decisions of the Administrator that serve as 

precedent final opinions and orders and statements of policy and 

inteipretation. They provide clarification and interpretation of complex or 

ambiguous provisions of the law or regulations relating to Medicare, 

Medicaid, Utilization and Quality Control Peer Review, private health 

insurance, and related matters. 

The rulings can be accessed at http://www.crns.gov/Regulationsand-Guidance/Guidance/Rulings. For questions or additional information, 

contact Tiffany Lafferty ( 410-786-7548). 

Addendum IV: Medicare National Coverage Determinations 

(January through March 2022) 

Addendum IV includes completed national coverage 

determinations (NCDs), or reconsiderations of completed NCDs, from the 

quarter covered by this notice. Completed decisions are identified by the 

section of the NCD Manual (NCDM) in which the decision appears, the 

title, the date the publication was issued, and the effective date of the 

decision. An NCD is a determination by the Secretary for whether or not a 

particular item or service is covered nationally under the Medicare Program 

(title XVIII of the Act), but does not include a determination of the code, if 

any, that is assigned to a particular covered item or service, or payment 

determination for a particular covered item or service. The entries below include information concerning completed decisions, as well as sections on 

program and decision memoranda, which also announce decisions or, in 

some cases, explain why it was not appropriate to issue an NCD. 

Information on completed decisions as well as pending decisions has also 

been posted on the CMS website. For the purposes of this quarterly notice, 

we are providing only the specific updates to national coverage 

determinations (NCDs), or reconsiderations of completed NCDs published 

in the 3-month period. This information is available at: 

www.crns.gov/medicare-coverage-database/. For questions or additional 

information, contact Wanda Belle, MPA (410-786-7491). 

Title NCDM Transmittal Issue Date Effective 

Section Number Date 

Common Working File 

(CWF) Editing - National 

Coverage Determination NCD270.3 Rl1262OTN 02/10/2022 04/13/2021 (NCD) 270.3 Blood-Derived 

Products for Chronic, NonHealing Wounds 

Revisions lo National 

Coverage Determination 

(NCD) 240.2 (Home Use of NCD240.2 

Oxygen) and 240.2.2 (Home andNCD 11263 02/10/2022 09/27/2021 

Oxygen Use for Cluster 240.2.2 

Headache) Metastasis of 

Cancer 

An Omnibus CR Covering: 

(1) Removal of Two 

National Coverage 

Determination (NCDs), (2) 

Updates to the Medical Remove Nutrition 180.2 and Therapy (MNT) Policy, and 220.6; 11272 02/18/2022 01/01/2022 (3) Updates to the NCD 180.1 Pulmonary Rehabilitation 

(PR), Cardiac Rehabilitation (CR), and Intensive Cardiac 

Rehabilitation (ICR) 

Conditions of Coverage 

National Coverage 

Determination (NCD) 270.3 

Blood-Derived Products for 

Chronic, Non-Healing NCD 270.3 11214 01/20/2022 04/13/2021 

Wounds [Rescinds and 

replaces Transmittal 11171, 

dated Januarv 12. 20221 

Addendum V: FDA-Approved Category B Investigational Device 

Exemptions (IDEs) (January through March 2022) 

(Inclusion of this addenda is under discussion internally.) 
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Addendum VI: Approval Numbers for Collections of Information 

(January through March 2022) 

All approval numbers are available to the public at Reginfo.gov. 

Under the review process, approved information collection requests are 

assigned 0MB control numbers. A single control number may apply to 

several related information collections. This information is available at 

www.reginfo.gov/public/do/PRAMain. For questions or additional 

information, contact William Parham ( 410-786-4669). 

Addendum VII: Medicare-Approved Carotid Stent Facilities 

(January through March 2022) 

Addendum VII includes listings of Medicare-approved carotid 

stent facilities. All facilities listed meet CMS standards for performing 

carotid artery stenting for high risk patients. On March 17, 2005, we issued 

our decision memorandum on carotid artery stenting. We determined that 

carotid artery stenting with embolic protection is reasonable and necessary 

only if performed in facilities that have been determined to be competent in 

performing the evaluation, procedure, and follow-up necessary to ensure 

optimal patient outcomes. We have created a list of minimum standards for 

facilities modeled in part on professional society statements on competency. 

All facilities must at least meet our standards in order to receive coverage 

for carotid artery stenting for high risk patients. For the purposes of this 

quarterly notice, we are providing only the specific updates that have 

occurred in the 3-month period. This information is available at: 

http://www.cms.gov/MedicareApprovedFacilitie/CASF /list.asp#TopOfPage 

For questions or additional information, contact Sarah Fulton, MHS 

(410-786-2749). 

Facility Provider Date State 

Number Aooroved 

Well star North Fulton Hospital 1033135959 01/18/2022 GA 

3000 Hospital Boulevard 

Roswell, GA 30076 

Sarasota County Public Hospital 10-0539 01/18/2022 FL 

District, d/b/ a Sarasota Memorial 

Hospital - Venice 

2600 Laurel Road E 

North Venice, FL 34275-3226 

Southern Hills Hospital & Medical 1457306359 02/08/2022 NV 

Center 9300 West Sunset Road 

Las Veeas NV 89148 

Mount Sinai South Nassau 330198 02/22/2022 NY 

One Healthy Way Oceanside NY 11572 

FROM: St. Joseph's Hospital 520037 06/28/2005 WI 

TO: Marshfield Medical Center 

Facility 

611 North Saint Joseph Avenue 

Marshfield, WI, 54449 Highline Medical Center 

16251 Sylvester Rd SW 

Burien, WA 98166 

Provider 

Number 

50-0011 

Addendum VIII: 

Date 

Approved 

10/17/2013 

State 

WA 

American College of Cardiology's National Cardiovascular Data 

Registry Sites (January through March 2022) 

The initial data collection requirement through the American 

College of Cardiology's National Cardiovascular Data Registry (ACCNCDR) has seived to develop and improve the evidence base for the use of 

I CDs in certain Medicare beneficiaries. The data collection requirement 

ended with the posting of the fmal decision memo for Implantable 

CardioverterDefibrillators on February 15, 2018. 

For questions or additional information, contact Sarah Fulton, 

MHS (410-786-2749). 

Addendum IX: Active CMS Coverage-Related Guidance Documents 

(January through March 2022) 

CMS issued a guidance document on November 20, 2014 titled 

"Guidance for the Public, Industry, and CMS Staff: Coverage with 

Evidence Development Document". Although CMS has several policy 

vehicles relating to evidence development activities including the 

investigational device exemption (IDE), the clinical trial policy, national 

coverage determinations and local coverage determinations, this guidance 

document is principally intended to help the public understand CMS's 

implementation of coverage with evidence development (CED) through the 

national coverage determination process. The document is available at http://www.cms.gov/medicare-coverage-database/details/medicarecoverage-document-detai1s.aspx?MCDid=27. There are no additional 

Active CMS Coverage-Related Guidance Documents for the 3-month 

period. For questions or additional information, contact 

Jo Anna Baldwin, MS ( 410-786-7205). 

AddendumX: 

List of Special One-Time Notices Regarding National Coverage 

Provisions (January through March 2022) 

There were no special one-time notices regarding national 

coverage provisions published in the 3-month period. This information is 

available at http://www.cms.gov. For questions or additional information, contactJoAnna Baldwin, MS ( 410-786 7205). 
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Addendum XI: National Oncologic PET Registry (NOPR) 

(January through March 2022) 

Addendum XI includes a listing of National Oncologic Positron 

Emission Tomography Registry (NOPR) sites. We cover positron emission 

tomography (PET) scans for particular oncologic indications when they are 

performed in a facility that participates in the NOPR. 

In January 2005, we issued our decision memorandum on positron 

emission tomography (PET) scans, which stated that CMS would cover 

PET scans for particular oncologic indications, as long as they were 

performed in the context of a clinical study. We have since recognized the 

National Oncologic PET Registry as one of these clinical studies. 

Therefore, in order for a beneficiary to receive a Medicare-covered PET 

scan, the beneficiary must receive the scan in a facility that participates in 

the registry. There were no additions, deletions, or editorial changes to the 

listing of National Oncologic Positron Emission Tomography Registry 

(NOPR) in the 3-month period. This information is available at 

http://www.cms.gov/MedicareApproveclFacilitie/NOPR/list.asp#TopOJPage. 

For questions or additional information, contact David Dolan, MBA ( 410-

786-3365). 

Addendum XII: Medicare-Approved Ventricular Assist Device 

(Destination Therapy) Facilities (January through March 2022) 

Addendum XII includes a listing of Medicare-approved facilities 

that receive coverage for ventricular assist devices (V ADs) used as 

destination therapy. All facilities were required to meet our standards in order to receive coverage for V ADs implanted as destination therapy. On October 1, 2003, we issued our decision memorandum on V ADs for the clinical indication of destination therapy. We determined that V ADs used as destination therapy are reasonable and necessary only if performed in 

facilities that have been determined to have the experience and 

infrastructure to ensure optimal patient outcomes. We established facility 

standards and an application process. All facilities were required to meet 

our standards in order to receive coverage for V ADs implanted as destination therapy. 

For the purposes of this quarterly notice, we are providing only the 

specific updates to the list of Medicare-approved facilities that meet our standards that have occurred in the 3-month period. This information is 

available at 

http://www.cms.gov/MedicareApprovedFacilitieNAD/list.asp#TopOtPage. 

For questions or additional information, contact David Dolan, MBA, 

( 410-786-3365). 

Facility Provider Date of In1tial Date of Re- I State 

Number Certification certification 

Bethesda '.forth Hospital 360179 12/16/2021 NIA I OH 

10500 Montgomery Road 

Cincinnati1 OH 45242 

Other information: 

DNVID# 

10000515749-MSC-DNVUSA 

Previous Re-certification Dates: n/a 

Facility Provider Date of In1tial Date of Re- State 

Number Certification certification 

FROM: lntennountain 460010 10/23/2003 11/11/2021 UT 

Medical Center; 

TO: Intermountain 

Healthcare Health Services 

htc. 

5121 South Cottonwood Street 

Murry, UT 84157 

Other information: 

Joint Commission ID# 9540 

Previous Re-certification Dates: 

10/31/2008; 12/07/2010; 12/11/2012; 12/16/2014; 

01/24/2017· 3/13/2019 

St. Vincent Hospital and 150084 01/0512004 11/06/2021 N 

Health Care Services, Inc. 

2001 West 86th Street 

Indianapolis, IN 46260 

Other information: 

Joint Commission ID # 7178 

Previous Re-certification Dates: 

12/16/2008; 05/17/2011; 

06/25/2013; 05/19/2015; 06/13/2017; 7/31/2019 

Montefiore Health System 330059 11/14/2003 10/29/2021 NY 

111 East 210th Street 

Bronx, NY 10467 

Other information: 

Joint Commission ID# 2514 

Previous Re-certification Dates: 

09/23/2008; 10/08/2010; 

10/23/2012; 09/23/2014; 10/18/2016; 11/07/2018 

Mayo Clinic Arizona 030103 02/27/2009 10/30/2021 AZ 

5777 East Mayo Boulevard 

Phoenix, AZ 85054 
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Facility Provider Date of Initial DateofRc- State Facility Provider Date of Initial DateofRc- State 

Number Certification certification Number Certification certification 

Other information: Previous Re-certification 

Joint Commission ID# 261796 Dates: 12/18/2014; 

01/24/2017; 03/06/2019 

Previous Re-certification Aurora Health Care Metro Inc. 520138 02/03/2009 01/06/2022 WI 

Dates: St. Luke's Medical Center 

01/27/2009; 04/29/2011; 2900 W Oklahoma Ave 03/20/2013; 03/24/2015; Milwaukee, WI, 53215 

05/19/2017· 8/14/2019 

UMass Memorial Medical 220163 02/06/2019 11/06/2021 MA Other information: 

Center, Inc. DNVID# 

55 Lal(e Ave North 10000509687-MSC-DNVWorcester, MA 01655 USA 

Other information: Previous Re-certification 

Joint Commission ID # 5640 Dates: 

02/03/2009; 08/09/2011; 

Previous Re-certification 07/17/2013; 07/21/2015; Dates: ll/14/2017· 2/12/2020 

02/06/2019 UT Southwestern William P. 450044 12/17/2008 02/12/2022 TX 

TO: North Carolina Baptist 340047 06/27/2011 10/16/2021 NC Clements Jr. University 

Hospital DBA Wake Forest Hospital Baptist Medical Center; 6201 Harry Hines Boulevard FROM: North Carolina Dallas, TX 75390-9262 Baptist Hospital dba Atrium 

Health Wake Forest Baptist Other information: 

Medical Center Boulevard Joint Commission ID # 9013 

Winston Salem, NC 27157 

Previous Re-certification 

Other information: Dates: 

Joint Commission ID# 6571 12/17/2008; 06/07/20ll; 

06/04/2013; 06/23/2015; 

Previous Re-certification 08/08/2017; 10/11/2019 

Dates: 06/28/2011; !nova Fairfax Hospital 490063 12/09/2008 11/17/2021 VA 

08/13/2013; 08/04/2015; 3300 Gallows Road 08/18/2017; 10/9/2019 Falls Church, VA 22042 

Temple University Hospital, 390027 02/08/2012 10/13/2021 PA 

Inc. Other information: 

3401 North Broad Street Joint Commission ID # 6351 

Philadelphia, PA 19140 

Previous Re-certification 

Other information: Dates: 

Joint Commission ID# 6152 12/09/2008; 03/22/2011; 

05/01/2013; 06/09/2015; 

Previous Re-certification 07/25/2017; 9/25/2019 

Dates: 

02/11/2014; 04/07/2016; 04/04/2018 

St. Luke's University Hospital 390049 12/18/2014 10/30/2021 PA 

801 Ostrum Street 

Bethlehem, PA 18015 

Other information: 

Joint Commission ID # 6024 
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Facility Provider Date of Initial Date of Re- State Facility Provider Date of Initial Date of Re- State 

Number Certification certification Number Certification certification 

Hartford Hospital 070025 03/31/2009 12/15/2021 CT Joint Commission lU # 2768 

80 Seymour Street 

Hartford, CT 06102-5037 Previous Re-certification 

Dates: 

Other information: 07/18/2017; 9/11/2019 

Joint Commission ID # 070025 Yale New Haven Hospital 070022 01/25/2011 11/24/2021 CT 

20 York Street 

Previous Re-certification New Haven, CT 06510-3203 Dates: 

03/31/2009; 11/16/2011; Other information: 

10/22/2013; 10/20/2015; Joint Commission ID # 5677 

11/14/2017; 12/10/2019 

UCSF Medical Center 050454 09/19/2012 11/18/2021 CA Previous Re-certification 

50 5 Parnassus Avenue Dates: 

San Francisco, CA 94143 01/25/2011; Ol/15i2013; 

12/16/2014; 02/28i2017; 

Other information: 5/22i2019 

Joint Commission ID# 10095 Shands Teaching Hospitals & 100113 11/26/2003 12/16/2021 FL 

Clinics, Inc, 

Previous Re-certification 1600 SW Archer Rd 

Dates: Gainesville, FL 32608 

09/19/2012; 11/04/2014; 

12/06/2016; 1/30/2019 Other information: 

Previous re-certification dates: Joint Commission ID # 6804 

10/01/2018 

Loyola University Medical 140276 05/10/2011 11/17/2021 IL Previous Re-certification 

Center Dates: 

2160 South First Avenue 11/18/2008; 02/08i2011; 

Maywood, IL 60153 02/12/2013; Ol/27i2015; 

02/14/2017; 04/24i2019 

Other information: Stanford Health Care 050441 12/22/2003 12/15/2021 CA 

Joint Commission ID # 7288 300 Pasteur Drive 

Stanford, CA 94305 

Previous Re-certification Dates: Other information: 

05/10/2011; 04/16/2013; Joint Commission ID# 10010 

03/17/2015; 05/09/2017; 

6/26/2019 Previous Re-certification 

Hackensa~k University 310001 10/20/2015 12/15/2021 NJ Dates: 

Medical Center 11/24/2010; 12/12i2012; 

30 Prospect Avenue 12/09/2014; 03/14i2017; 

Hackensack, NJ 07601 08/28/2019 

Deborah Heart and T ,ung 310031 02/05/2019 02/10/2022 NJ 

Other information: Center 

Joint Commission IT)# 5934 200 Trenton Rd 

Browns Mills, NJ 08015 

Previous Re-certification Dates: Other information: 

10/20/20 I 5; 09/19/2017; DNV ID # C522707 

10/4/2019 

Baystate Medical Center 220077 07/18/2017 12/04/2021 MA Previous Re-certification 

759 Chestnut Street Dates: 02/05/2019 

Springfield, MAO 1199 Memorial Hermann - Texas 450068 04/10/2013 12/23/2021 TX 

Medical Center 

Other information: 6411 Fannin Street 
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Facility Provider Date of Initial Date of ReNumber Certification certification 

Houston, TX 77030 

Other information: 

Joint Commission ID # 9081 

Previous Re-certification Dates: 03/19/2013; 2015-

04/14/2015; 05/24/2017; 06/26/2019 

Mayo Clinic Florida 100151 03/17/2009 01/15/2022 

4500 San Pablo Road 

Jacksonville, FL 32224 

Other information: 

Joint Commission ID # 369946 

Previous Re-certification Dates: 

03/17/2009; 10/19/2011; 09/24/2013; 09/15/2015; 

10/03/2017· 11/6/2019 

Einstein Medical Center 390142 08/24/2011 01/15/2022 

Philadelphia 

5501 Old York Road 

Philadelphia, PA 19141 

Other information: 

Joint Commission ID # 6118 

Previous Re-certification Dates: 

08/24/2011; 08/20/2013; 08/04/2015; 09/19/2017; 

10/23/2019 

Addendum XIII: Lung Volume Reduction Surgery (LVRS) 

(January through March 2022) 

State 

FL PA 

Addendum XIII includes a listing of Medicare-approved facilities 

that are eligible to receive coverage for lung volume reduction surgery. 

Until May 17, 2007, facilities that participated in the National Emphysema 

Treatment Trial were also eligible to receive coverage. The following three 

types of facilities are eligible for reimbursement for Lung Volume 

Reduction Surgery (L YRS): 

• National Emphysema Treatment Trial (NETT) approved (Beginning 

05/07/2007, these will no longer automatically qualify and can qualify only 

with the other programs); 

• Credentialed by the Joint Commission (formerly, the Joint 

Commission on Accreditation of Healthcare Organizations (JCAHO)) under 

their Disease Specific Certification Program for L YRS; and 

• Medicare approved for lung transplants. 

Only the first two types are in the list. There were no updates to 

the listing of facilities for lung volume reduction surgery published in the 

3-month period. This information is available at 

www.cms.gov/MedicareApprovedFacilitie/L VRS/list.asp#TopOfPage. For 

questions or additional information, contact Sarah Fulton, MHS 

(410-786-2749). 

Addendum XIV: Medicare-Approved Bariatric Surgery Facilities 

(January through March 2022) 

Addendum XIV includes a listing of Medicare-approved facilities 

that meet minimum standards for facilities modeled in part on professional 

society statements on competency. All facilities must meet our standards in 

order to receive coverage for bariatric surgery procedures. On February 21, 

2006, we issued our decision memorandum on bariatric surgery procedures. 

We determined that bariatric surgical procedures are reasonable and 

necessary for Medicare beneficiaries who have a body-mass index (BMI) 

greater than or equal to 35, have at least one co-motbidity related to obesity 

and have been previously unsuccessful with medical treatment for obesity. 

This decision also stipulated that covered bariatric surgery procedures are 

reasonable and necessary only when performed at facilities that are: (1) 

certified by the American College of Surgeons (ACS) as a Level 1 Bariatric 

Surgery Center (program standards and requirements in effect on February 

15, 2006); or (2) certified by the American Society for Bariatric Surgery 

(ASBS) as a Bariatric Surgery Center of Excellence (ESCOE) (program 

standards and requirements in effect on February 15, 2006). 

There were no additions, deletions, or editorial changes to 

Medicare-approved facilities that meet CMS' minimum facility standards 

forbariatric surgery that have been certified by ACS and/or ASMBS in the 

3-month period. This information is available at 

www.cms.gov/MedicareApprovedFacilitie/BSF /list.asp#TopOfPage. For 

questions or additional information, contact Sarah Fulton, MHS 

(410-786-2749). 

Addendum XV: FDG-PET for Dementia and Neurodegenerative 

Diseases Clinical Trials (January through March 2022) 

There were no FDG-PET for Dementia and Neurodegenerative 

Diseases Clinical Trials published in the 3-month period. 

This information is available on our website at 

www.cms.gov/MedicareApprovedFacilitie/PETDT/list.asp#TopOfPage. 

For questions or additional information, contact David Dolan, MBA ( 410-

786-3365).