Date Posted: June 11, 2026

This Billing and Coding article has been revised and published for notice under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).

Effective Date: January 1, 2026

Summary of Article Changes:

Added the following statement under Article Text Section:

For Type of Bill (TOB) 018X, Respiratory care is included in Payment Driven Payment Model (PDPM); Exception allows CAH to be paid separately.

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