Manual Updated 03/01/18 2026

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CMS updates the NCCI Policy Manual for Medicare Services once a year. The NCCI Policy Manual should be used by Medicare Administrative Contractors (MACs) as a general reference tool that explains the rationale for NCCI edits. Additions and revisions to the manual are noted in red font.
Important Point: The KX modifier, alone, indicates you are requesting an exception for the untimely NOE. Hospices can provide sufficient information in the REMARKS field (FISS Page 04) that clearly indicates all the circumstances and time frames supporting the exception request.
CMS maintains HCPCS Level II codes, including decisions about additions, revisions, and deletions to the codes.
Home health and hospice billing transactions, including, claims, and adjustments must be submitted no later than 12 months, or 1 calendar year, after the date the services were furnished.
Hospice providers must use revenue code 0657 when billing for pain- and symptom-management services related to a recipients terminal condition and provided by a physician employed by, or under arrangement made by, the hospice. Revenue code 0657 should be billed on a separate line for each date of service.

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