Hospital OPPS: July 2025 Update

Related CR Release Date: June 23, 2025 
MLN Matters Number: MM14091
Effective Date: July 1, 2025 
Related Change Request (CR) Number: CR 14091
Implementation Date: July 7, 2025 
Related CR Transmittal Number: R13258CP

CR14091 includes coding and billing changes for:

  • New COVID-19, influenza, and respiratory syncytial virus vaccines
  • COVID-19 monoclonal antibody therapy products, proprietary laboratory analyses (PLA) codes, and Hospital Outpatient Prospective Payment system (OPPS) device categories 
  • Status indicator changes
  • Drugs, biologicals, and radiopharmaceuticals
  • Skin substitutes

Make sure your billing staff knows about these updates effective July 1, 2025.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)14091.

Last Updated Jul 03 , 2025