MMSEA Section III NGHP User Guide Update
On November 18, 2025, the Centers for Medicare & Medicaid Services (CMS) released the MMSEA Section 111 NGHP User Guide to version 8.2, revised on October 6, 2025. The latest version has been posted to the NGHP User Guide page, found here. The NGHP User Guide to version 8.2 replaces Version 8.1, which was released on May 5, 2025.
MMSEA III – November 18, 2025 – NGHP User Guide version 8.2 Summary of Version 8.2 Updates
Chapter 1: Introduction and Overview
The updates listed below have been made to the Introduction and Overview Chapter Version 8.2 of the NGHP User Guide. As indicated in prior Section 111 NGHP Town Hall teleconferences, the Centers for Medicare & Medicaid Services (CMS) continues to review reporting requirements and will post any applicable updates in the form of revisions to Alerts and the user guide as necessary. There are no changes for this version.
Chapter II: Registration Procedures
The update listed below has been made to the Registration Procedures Chapter Version 8.2 of the NGHP User Guide. As indicated in prior Section 111 NGHP Town Hall teleconferences, the Centers for Medicare & Medicaid Services (CMS) continues to review reporting requirements and will post any applicable updates in the form of revisions to Alerts and the user guide as necessary. There are no changes for this version.
Chapter III: Policy Guidance
The updates listed below have been made to the Policy Guidance Chapter Version 8.2 of the NGHP User Guide. As indicated in prior Section 111 NGHP Town Hall teleconferences, the Centers for Medicare & Medicaid Services (CMS) continues to review reporting requirements and will post any applicable updates in the form of revisions to Alerts and the user guide as necessary. Language has been updated to clarify different situations where it may be appropriate to submit multiple records for a single individual (Section 6.5.1.3).
Chapter IV: Technical Information
The updates listed below have been made to the Technical Information Chapter Version 8.2 of the NGHP User Guide. As indicated on prior Section 111 NGHP Town Hall teleconferences, the Centers for Medicare & Medicaid Services (CMS) continues to review reporting requirements and will post any applicable updates in the form of revisions to Alerts and the user guide, as necessary. The number of days required to generate a response file for claim files has been corrected from 48 to 33 (Chapter 7). Starting April 2026, new reason codes will be available to further improve granularity and clarity of updates to MSP and drug coverage records. The new codes have been added to the Change Reason Description table with an asterisk (*) (Table 7-4).
Chapter V: Appendices
The updates listed below have been made to the Appendices Chapter Version 8.2 of the NGHP User Guide. As indicated on prior Section 111 NGHP Town Hall teleconferences, the Centers for Medicare & Medicaid Services (CMS) continue to review reporting requirements and will post any applicable updates in the form of revisions to Alerts and the user guide as necessary. The definitions of field 43 of the Claim Input File Detail Record table and CW09 of the Claim Response File Error Code Resolution table have been expanded for clarification (Appendix A and Appendix G). To ensure consistency of data the Recovery Agent TIN field is required if agent name is submitted (Appendix B and Appendix G).
270/271 Health Care Eligibility Benefit Inquiry and Response Companion Guide for Mandatory Reporting Non-GHP Entities Version 6.0
The email address for contacting an Electronic Data Interchange (EDI) Representative has changed to COBVA@bcrcgdit.com. However, COBVA emails coming from CMS now show the address as COBVA@mail.cms.hhs.gov (Customer Support).
For Additional Information
Medivest will continue to monitor changes occurring at CMS and will keep its readers up-to-date when such changes are announced. For questions, feel free to reach out to the Medivest representative in your area by clicking here or calling us directly at 877.725.2467.
