Plain-English answers for Medicare and state Medicaid. Every answer is tied to an official public source, a page or section, a source date, and a last-checked date.
PPS Playbook covers Medicare FQHC PPS, Medicare Advantage (the MAC supplemental “wrap” payment plus public plan-manual rules), plus Medicaid fee-for-service and managed Medicaid in the states listed above. Every entry was written from an official public document that was read and last checked on the date shown. When a source was old, unofficial, or silent on a point, the card says so in its confidence note. Rates are never estimated.
How sources are checked: each answer was read directly in the cited official document (section or page shown on the card). A script then requests every source link, records its HTTP status, and saves a SHA-256 fingerprint of the file, so a later run shows which documents moved, broke, or changed and need re-reading. Medicare Advantage plan rules come from public plan manuals and can differ by your contract with the plan.
CPT is a registered trademark of the American Medical Association. This site lists CPT code numbers only. HCPCS Level II summaries are written in plain English, in our own words.
Every 2026 UDS table and form, with denominators, numerators, exclusions, CY 2026 changes, and the matching CMS eCQM and HEDIS measure. All text is quoted from HRSA’s PAL 2026-05 and the 2026 UDS Manual, with page citations.