January 11, 2016
CMS To Hold 2016 Date-of-Service Claims for Services Paid Under the 2016 MPFS
The CMS announcement is as follows:
Holding of 2016 Date-of-Service Claims for Services Paid Under the 2016 MPFS
On October 30, 2015, the CY 2016 Medicare Physician Fee Schedule (MPFS) final rule was published in the Federal Register. In order to implement corrections to technical errors discovered after publication of the MPFS rule and process claims correctly, Medicare Administrative Contractors will hold claims containing 2016 services paid under the MPFS for up to 14 calendar days (i.e., Friday January 1, 2016 through Thursday January 14, 2016). 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.
MPFS claims for services rendered on or before Thursday December 31, 2015, are unaffected by the 2016 claims hold and will be processed and paid under normal procedures and time frames.