January 05, 2015
Area(s) of Interest: Payor Issues and Reimbursement Public Payors
Last week the Centers for Medicare and Medicaid Services (CMS) announced it would hold claims for services paid under the 2015 Medicare physician fee schedule due to technical errors discovered after the new fee schedule was published.
Medicare Administrative Contractors (MACs) will hold claims containing 2015 services for the first 14 calendar days of January 2015 (Thursday January 1 through Wednesday January 14) to allow time for CMS to correct the errors.
The hold should have minimal impact on provider cash flow as, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.
Claims for services rendered on or before Wednesday December 31, 2014, are unaffected by the 2015 claims hold and will be processed and paid under normal procedures and time frames.