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Medicare Claims Processing

Congress has yet to pass legislation halting the 21.3% Medicare Physician Fee Schedule reduction. Contractors held claims an extra three days hoping for a resolution, but to no avail. As a result, contractors have now been instructed to release claims for payment on a first in, first out basis. If and when Congress passes an update, contractors will reprocess claims paid out at the lower fee schedule.

In the meantime, however, some practices received conflicting information indicating that claims were being held indefinitely. This is not accurate. CMS’ instruction to contractors is to pay claims with the reduction. You should begin seeing checks for services provided June 1 and beyond at the reduced rate.

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