CMS Releases WCMSA Reference Guide Version 4.5
by M. Heberling
The Centers for Medicare & Medicaid Services (CMS) released an updated Workers’ Compensation Medicare Set-Aside Arrangements (WCMSA) Reference Guide version 4.5, on April 13, 2026.
CMS made minimal changes from the prior version of the guide. ZIP codes were added to the table listing major medical centers in Appendix 7, which will likely have a minor impact on surgeries and procedures included in CMS approvals.
CDC Life Table
The link to the current version of the Life Table for the total population: United States, 2023 being applied to MSAs was also fixed, as indicated in Section 10.3 of the guide. Please note that if you follow the link to the document, the appropriate table (Table 1) can be found on page 14. Use Column ex to identify the life expectancy that CMS will use for their approval process. If the Rated Age being utilized is 65, then you would use the line for 65-66 (not 64-65) to identify the life expectancy in Column ex.
Where to Find the Latest Version
An announcement regarding the new version of the guide can be found on the What’s New page of the Workers’ Compensation Medicare Set Aside Arrangements section of CMS.gov.
If you have any questions about the WCMSA reference guide, or would like more information about our WCMSA options and mitigation strategies, please contact the IMPAXX Settlement Consulting team at [email protected].