On April 24, 2026, the Centers for Medicare & Medicaid Services (CMS) initiated a public comment period regarding two distinct information collection activities. This move, announced in the Federal Register, signifies CMS's ongoing commitment to regulatory transparency and efficiency under the Paperwork Reduction Act of 1995. Stakeholders are invited to provide input on data collection practices critical to healthcare coding and the oversight of rehabilitation facilities, thereby influencing the operational framework of Medicare and related health services.
Information Collection 1: HCPCS Modification to Code Set Form
The first notice pertains to a proposed revision of a currently approved information collection concerning the CMS Healthcare Common Procedure Coding System (HCPCS) Modification to Code Set Form. This collection, identified as CMS-10244 with OMB control number 0938-1042, is fundamental to how medical items, supplies, and services are categorized and reimbursed within the healthcare system. The HCPCS Level II code set, also known as alpha-numeric codes, serves as a standardized system primarily for identifying items, supplies, and services not typically included in the HCPCS Level I Current Procedural Terminology (CPT) codes.
These codes are extensively used for ambulatory services, durable medical equipment, prosthetics, orthotics, supplies utilized in home or outpatient settings, and certain drugs and biologicals. Their establishment enables Medicare and other insurers to process claims efficiently by assigning codes that classify similar medical items or services into categories. The descriptive terminology associated with each alpha-numeric HCPCS code identifies a specific category of like items.
CMS is mandated by 42 CFR Sec. 414.40(a) to establish uniform national definitions of services, codes to represent these services, and payment modifiers. The maintenance of the HCPCS code set is an active and continuous process, driven by information received from applicants. Changes and updates are implemented quarterly for drug and biological products and biannually for non-drug and non-biological items or services. This continuous collection of information from applicants is essential as new technology evolves and new devices, drugs, and supplies are introduced to the market, necessitating modifications to the HCPCS Level II code set. The annual burden estimate for this collection involves 250 respondents, with 250 total annual responses, totaling 2,500 annual hours.
Information Collection 2: Conditions of Participation for Comprehensive Outpatient Rehabilitation Facilities (CORFs)
The second notice concerns a request for reinstatement, with change, of a previously approved information collection related to the Conditions of Participation (CoPs) for Comprehensive Outpatient Rehabilitation Facilities (CORFs). This collection, identified as CMS-10282 with OMB control number 0938-1091, is vital for ensuring the quality and safety of care provided by these facilities.
CORFs play a crucial role in the healthcare landscape by offering coordinated outpatient diagnostic, therapeutic, and restorative services designed to rehabilitate individuals who are injured, disabled, or ill. These facilities are required to provide core services, including physician consultation and supervision of staff, oversight of treatment plans, facility administration, physical therapy, and social or psychological services. These services may also be offered at single, off-site locations.
The information collections described herein enable CMS to verify that CORFs comply with both initial and ongoing Medicare CoPs, which are specified in Title 42 Code of Federal Regulations Section 485, Subpart B. These CoPs are fundamental for assuring a minimal level of patient health and safety in participating facilities and for ensuring that Medicare requirements are consistently met. Specifically, the CoP at 42 CFR 485.66 includes two information collection components: IC-1a for newly certified CORFs to develop a Utilization Review Plan and IC-1b for currently certified CORFs to conduct Annual Utilization Reviews.
Notably, the estimated annual hourly burden for this collection has been revised downward from 1,504 hours to 1,260 hours, representing a 16 percent decrease. The annual burden cost is now estimated at $108,190. This reduction in burden hours is primarily attributed to a decrease in the number of certified CORFs, from 188 in the prior iteration to 155 in this reinstatement. Additionally, the explicit inclusion of IC-1a for newly certified CORFs, which was unintentionally omitted in the prior request but is not a new requirement, contributes to a more accurate burden assessment. The collection involves 158 respondents, with 158 total annual responses, totaling 1,260 annual hours.
Implications and Outlook
The public comment period for both these information collections presents a critical juncture for various stakeholders, including healthcare providers, industry groups, and patient advocacy organizations, to influence federal regulatory practices. For the HCPCS code set, the ability to provide input ensures that the coding system remains adaptable to advancements in medical technology and services. This adaptability is essential for accurate billing, appropriate reimbursement, and ultimately, patient access to innovative care. The continuous update process, driven by applicant submissions, highlights the dynamic nature of healthcare and the need for robust regulatory mechanisms.
Regarding CORFs, the modifications to the information collection request reflect CMS's ongoing efforts to streamline administrative processes while upholding rigorous standards for patient care and safety. The decrease in reported burden hours for CORFs, alongside the clarification of requirements for newly certified facilities, indicates a responsive approach to regulatory oversight. This adjustment aims to reduce unnecessary administrative burdens on rehabilitation facilities while maintaining the necessary safeguards to protect vulnerable patients receiving outpatient services. The comments received will help CMS refine these processes, balancing the need for data with the practicalities of compliance for healthcare entities. The outcome of these comment periods will shape the operational landscape for a broad segment of the healthcare industry, influencing both economic considerations for providers and the quality of care for patients.
