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US CMS Provider Education Message

US CMS Provider Message

Medicare Reimbursement Update – 4-2-15

The negative 21% payment rate adjustment under current law for the Medicare Physician Fee Schedule is scheduled to take effect on April 1, 2015.  The Centers for Medicare and Medicaid Services (CMS) is taking steps to limit the impact on Medicare providers and beneficiaries by holding claims for a short period of time beginning on April 1.  Holding claims for a short period of time allows CMS to implement any subsequent Congressional action while minimizing claims reprocessing and disruption of physician cash flow in the event of legislation addressing the 21% payment reduction.  Under current law, electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.  CMS will provide more information about next steps by April 11, 2015.


3-25-2015: Attention Health Professionals: Information Regarding the 2015 Medicare Physician Fee Schedule 
The negative update of 21% under current law for the Medicare Physician Fee Schedule is scheduled to take effect on April 1, 2015.  Medicare Physician Fee Schedule claims for services rendered on or before March 31, 2015, are unaffected by the payment cut and will be processed and paid under normal procedures and time frames.  The Administration urges Congress to take action to ensure these cuts do not take effect.  However, until that happens, CMS must take steps to implement the negative update.  Under current law, electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.  CMS will notify you on or before April 11, 2015, with more information about the status of Congressional action to avert the negative update and next steps.

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