Medicare Administrative Contractors Will Hold Claims Until January 14

CMS announced that Medicare Administrative Contractors (MACs) will hold claims containing 2015 services paid under the Medicare Physician Fee Schedule (MPFS) for the first 14 calendar days of January 2015 (Thursday January 1 through Wednesday January 14).  Technical errors were discovered after publication of the MPFS rule in November and in order to process claims correctly, CMS is holding claims through January 14, 2015. 
 
CMS states that this 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 for paper claims) after the date of receipt.
 
MPFS claims for services rendered on or before Wednesday December 31, 2014 are unaffected by the 2015 claims hold and will be processed under normal procedures and normal time frames.  In order to avoid payment delays once the claims are processed, providers should continue submitting timely claims from January 1 through January 14. 
 
 If you have any questions, please contact Ashley McGlone, Manager of Regulatory Affairs, at 703-591-2200.