On February 19, 2026, CMS declared in Change Request (CR) 14382 that it would implement consistency edits for provider-based department (PBD) claims on July 6, 2026, with an effective date of July 1. No new policy is being implemented as a result of this CR.

The new edit will tighten consistency of processing on outpatient off-campus PBD claims that are required to contain a modifier ER, PO, or PN. There are few exceptions to this rule. Any PBD claims that are missing one of these modifiers will Return to Provider (RTP).

Read the full CR 14382.