Urgent Action Needed for Medicaid Compliance: Referring NPI billing requirements See attached text copied from the SC-APTA newsletter

CMS Proposes New Model That Could Highlight PTs’ Impact in Joint Replacement | APTA In its fiscal year 2027 Inpatient Prospective Payment System proposed rule, the Centers for Medicare & Medicaid proposed a nationwide expansion of its Comprehensive Care for Joint Replacement model. APTA will be submitting comments on the model, which the agency is calling “CJR-X”, by the June 9 deadline.

Professional fee schedule increase for September 1, 2026 Blue Cross Blue Shield of Massachusetts will update our commercial professional provider fee schedule effective for dates of service on or after September 1, 2026. Reimbursement for physical therapy services will increase in aggregate by 2%. Updates will be based on the Centers for Medicare & Medicaid Services’ (CMS’) 2026 adjustments to its Relative Value Units (RVUs)*.

MEDICARE -- As of April 2026, 1.3 million Medicare beneficiaries are receiving new Medicare Beneficiary Identifier (MBI) numbers due to suspected data breaches. These new numbers became effective on April 14, 2026. Claims submitted with the old MBI for services on or after April 14, 2026, are being denied because the identifier is technically terminated. Are you seeing the "reason code 31605 or U5065, indicating an invalid or terminated MBI?" For dates of service entirely on or after April 14, 2026, the old MBI is no longer valid, requiring a resubmission with the updated identifier.