CMS Releases NGHP User Guide Version 8.5

by F. Fairchok

The Centers for Medicare & Medicaid Services (CMS) released an update to the Non-Group Health Plan (NGHP) Section 111 Reporting User Guide on July 13, 2026. The refreshed User Guide, Version 8.5, contains the following minor updates:

Error Code CW08 Clarification

Error code CW08 has been updated to note that if the Claim Input File Detail Record is provided and does not match the existing Workers’ Compensation Set-Aside (WCMSA) case, the record will be rejected (Chapter V, Appendix G).

New GL Disposition Code

Effective January 2027, when a Claim Response File is submitted and a record is not accepted by the Benefits Coordination & Recovery Center (BCRC) because it is part of a Global Resolution Settlement, a new Disposition Code “GL” will result. (Chapter V, Appendix G).

Foreign Addresses in TIN Records

To reduce errors in address checks, it is no longer advisable to enter all zeros when entering a ZIP code when using the “FC” code (Chapter V – Appendices A, B, D and G). The new guidance is to fill the field with spaces instead of zeros.

Submission Alerts and Emails

To eliminate false early and late alerts and emails, to reduce time spent investigating non-issues, and to reduce confusion and incorrect escalations, the Early File Submission and Late File Submission alerts and emails have been discontinued. (Chapter II, Section 4.3.2)

 Automatic File Deletion

To improve efficiency, files that have been in MSP HOLD (TIN) error status or Severe Error status will automatically be deleted after 35 days (Chapter IV, Sections 6.3.3, 7.3.1, and 8.3).

If you have questions about updates made in version 8.5 of the guide or would like further guidance on Medicare Secondary Payer (MSP) compliance, don’t hesitate to email our experienced MSP Reporting services team at [email protected].