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Medicare Physician Fee Schedule Update - Part B Claims Pricing Error Posted April 23, 2010UPDATED: 04/20/2010 @ 11:10 AM - Medicare Physician Fee Schedule Update - Part B Claims Pricing Error (click for details)
On April 15, 2010, President Obama signed into law the "Continuing Extension Act of 2010." This law extends through May 31, 2010, the zero percent update to the MPFS that was in effect for claims with dates of service January 1, 2010 through March 31, 2010. The law is retroactive to April 1, 2010.
As instructed previously by CMS, Highmark Medicare Services (HMS) has been holding all Part B claims with dates of service April 1, 2010 and after, that were to be paid based on the Medicare Physician Fee Schedule. HMS did release claims for dates of services on or after April 1, 2010, received between April 1, 2010 and April 7, 2010; however, due to an internal system error, these claims potentially paid at the incorrect -21% reduced fee schedule. Systems corrections have been made, and claims paid at the incorrect -21% fee will be reprocessed automatically. HMS plans to continue releasing held claims on a first in first out basis, which will process with the correct fee schedule.
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