Fee Schedule Maintenance Update

We’re making updates to current codes which lacked a fixed pricing methodology. These updates are aligned with the January version of the Centers for Medicare & Medicaid Services (CMS) fee schedules and are effective July 15, 2025.

This new fixed pricing will apply to some codes in the following categories:

• Clinical laboratory (CLAB)
• Durable medical equipment (DME)
• Parenteral and enteral nutrition (PEN)
• Resource-based relative value scale (RBRVS).

Please see below for a list of updated codes and payment classifications.

You can review the CMS file, All Fee-For-Service Providers | CMS to locate the RBRVS, DME, CLAB, and PEN weights necessary to apply to your contracts and determine the allowable amounts for these updated codes.

Please note that if your contract contains specific language about pricing updates, this update may not apply to you. Please refer to your specific compensation exhibit or addendum to clarify how this update impacts your reimbursement.

More detailed information and additional codes will be mailed out to you within the next few weeks.

If you have questions or need clarification, please email our provider relations team.