CMS Announces a Two Week Claims-Processing Hold

Centers for Medicare & Medicaid Services (“CMS”) has issued the following announcement regarding a two-week hold on the processing of Medicare claims beginning January 1, 2015 through January 14, 2015 for claims with 2015 dates of service. CMS has instituted the hold to allow the Medicare Administrative Contractors (“MACs”) sufficient time to implement RVU and conversion factor changes to the Medicare Physician Fee Schedule effective January 1, 2015. CMS’s official announcement is provided below.

Holding of 2015 Date-of-Service Claims for Services Paid Under the 2015 Medicare Physician Fee Schedule

On November 13, 2014, the CY 2015 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 2015 services paid under the MPFS for the first 14 calendar days of January 2015 (i.e., Thursday January 1 through Wednesday January 14). 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 Wednesday Dec 31, 2014 are unaffected by the 2015 claims hold and will be processed and paid under normal procedures and time frames.