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The Questions and Answers below apply to the recent decision by the Centers for Medicare & Medicare Services to hold for up to 10 business days claims paid under the Medicare physician fee schedule (MPFS) that contain July 2008 dates of service.
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Will claims containing services paid under the MPFS be held that contain both June and July dates of service? |
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A.
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Yes, your local contractor will hold the entire claim for 10 business days. |
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Will claims be held that contain both services paid under the MPFS and services paid under a separate fee schedule? |
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Yes, claims that contain both services paid and not paid under the MPFS will be held. For example, a claim with a July date containing an Evaluation and Management code and a drug code would be held. |
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Does the holding of claims paid under the MPFS also include anesthesia and purchased diagnostic services? |
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Yes, contractors will hold all claims with dates of service July 1, 2008, and after that contain services paid under the MPFS, including anesthesia and purchased diagnostic services. |
Last Published: 7/2/2008 Print this page
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